Disclosure of interests: The authors of this article attest that there are no financial or other relationships that could be construed as a conflict of interest.
Article first published online: 27 DEC 2012
Copyright © 2012 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Volume 107, Issue 6, pages 585–590, 1 May 2013
How to Cite
Klaver, Y. L.B., Chua, T. C., Verwaal, V. J., de Hingh, I. H.J.T. and Morris, D. L. (2013), Secondary cytoreductive surgery and peri-operative intraperitoneal chemotherapy for peritoneal recurrence of colorectal and appendiceal peritoneal carcinomatosis following prior primary cytoreduction. J. Surg. Oncol., 107: 585–590. doi: 10.1002/jso.23303
Presented at the 5th International Symposium on Abdominal Metastatic Cancer, 4th and 5th of July 2011, Regensburg, Germany.
- Issue published online: 16 APR 2013
- Article first published online: 27 DEC 2012
- Manuscript Accepted: 14 NOV 2012
- Manuscript Received: 26 MAR 2012
- colorectal cancer;
- peritoneal carcinomatosis;
- cytoreductive surgery;
Primary cytoreductive surgery (CRS) and peri-operative intraperitoneal chemotherapy (PIC) is the only curative option for patients with colorectal cancer peritoneal carcinomatosis (PC). A significant proportion of patients develop peritoneal recurrence. Outcomes of patients undergoing secondary CRS and PIC for recurrent PC were examined.
All patients undergoing second procedures with curative intent for recurrent appendiceal or colorectal cancer PC in three centers were included. Patients with recurrent pseudomyxoma peritonei (PMP) were excluded. Morbidity and mortality, overall survival, and disease-free survival were primary outcome parameters.
The study included 18 patients (13 colorectal and 5 appendiceal cancer). At primary CRS, mean Peritoneal Cancer Index (PCI) was 9.1. In 13 patients complete resection was achieved. Median time to recurrence was 14 months (range: 1–33). At secondary CRS, mean PCI was 6.3 and CRS was complete in 13 patients. There was no 30-day mortality and 1- and 2-year survival were 74% and 50%, respectively. In 14 patients a recurrence after the second procedure was diagnosed.
A secondary CRS for recurrent colorectal or appendiceal cancer PC is safe and feasible, however, relapse is frequent. Further investigations are required to critically assess the efficacy of a secondary procedure and to define optimal patient selection criteria in the era of effective modern chemotherapy. J. Surg. Oncol. 2013;107:585–590. © 2012 Wiley Periodicals, Inc.