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Outcomes associated with cytoreductive surgery and intraperitoneal hyperthermic chemotherapy in colorectal cancer patients with peritoneal surface disease and hepatic metastases†

  1. Oliver Varban MD,
  2. Edward A. Levine MD,
  3. John H. Stewart MD,
  4. Thomas P. McCoy MS,
  5. Perry Shen MD‡,*

Article first published online: 4 JUN 2009

DOI: 10.1002/cncr.24385

Issue

Cancer

Cancer

Volume 115, Issue 15, pages 3427–3436, 1 August 2009

Additional Information

How to Cite

Varban, O., Levine, E. A., Stewart, J. H., McCoy, T. P. and Shen, P. (2009), Outcomes associated with cytoreductive surgery and intraperitoneal hyperthermic chemotherapy in colorectal cancer patients with peritoneal surface disease and hepatic metastases. Cancer, 115: 3427–3436. doi: 10.1002/cncr.24385

Author Information

  1. Department of General Surgery, Surgical Oncology Section, Wake Forest University School of Medicine, Winston-Salem, North Carolina

  1. ‡

    Fax: (336) 713-6959

*Department of General Surgery, Surgical Oncology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157

  1. †

    Presented as a podium presentation at the American Hepato-Pancreato-Billiary Association Annual Meeting, Fort Lauderdale, Florida, March 27–30, 2008.

  2. ‡

    Fax: (336) 713-6959

Publication History

  1. Issue published online: 20 JUL 2009
  2. Article first published online: 4 JUN 2009
  3. Manuscript Accepted: 7 JAN 2009
  4. Manuscript Revised: 9 DEC 2008
  5. Manuscript Received: 22 SEP 2008

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Keywords:

  • cytoreductive surgery;
  • intraperitoneal hyperthermic chemotherapy;
  • peritoneal carcinomatosis;
  • hepatic metastases;
  • peritoneal surface disease;
  • overall survival

Abstract

BACKGROUND:

Cytoreductive surgery (CS) and intraperitoneal hyperthermic chemotherapy (IPHC) can improve outcomes for selected patients with peritoneal carcinomatosis (PC) from colorectal cancer. The presence of parenchymal hepatic metastases (HM) is considered a relative contraindication for CS and IPHC. The purpose of the current study was to compare the overall survival of patients with HM to those without and to examine predictive factors.

METHODS:

This was a retrospective study of patients undergoing CS and IPHC between 1991 and 2007. Clinicopathologic information was obtained from a prospectively collected database and electronic medical records. Univariate and multivariate analyses were performed to evaluate variables predictive for overall survival.

RESULTS:

There were 142 patients who underwent CS and IPHC for PC from colorectal cancer, with 14 (9.9%) patients noted to have concurrent HM. The median number and size of the liver lesions was 1 (range, 1-7 lesions) and 3.0 cm (range, 0.4 cm-12 cm), respectively. The median overall survival for patients with HM was 23.0 months. Two-year and 4-year survival rates were 43.3% and 14.4%, respectively. Patients without HM had 2-year and 4-year survival rates of 36.8% and 17.4%, respectively. Overall survival was not significantly different for patients with and without HM (log-rank P = .39).

CONCLUSIONS:

Patients with HM undergoing CS and IPHC for colorectal cancer were found to have no significant difference in overall survival compared with those without HM. Most patients had a single small lesion treated with a minor hepatic resection. Further study is indicated to define which patients with HM benefit most from this multimodality approach. Cancer 2009. © 2009 American Cancer Society.

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