Clinical outcomes of complete cytoreduction with concurrent liver resection followed by hyperthermic intraperitoneal chemotherapy for synchronous peritoneal and liver metastatic colorectal cancer

World J Surg Oncol. 2019 Dec 11;17(1):214. doi: 10.1186/s12957-019-1746-x.

Abstract

Background: This study aimed to evaluate the clinical outcomes of concurrent liver resection with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer patients with synchronous liver and peritoneal metastases.

Methods: Patients with colorectal liver and peritoneal metastasis who underwent complete cytoreduction and hyperthermic intraperitoneal chemotherapy with concurrent liver surgery between September 2014 and July 2018 were included. Perioperative outcomes, overall survival, and progression-free survival were analyzed retrospectively.

Results: In total, 22 patients were included. The median peritoneal cancer index was 13 (range, 0-26), and the median number of liver metastases was 3 (range, 1-13). The mean total operative time was 11.4 ± 2.6 h. Minor postoperative complications (Clavien-Dindo grade I-II) were reported in 10 patients (45.5%), and major postoperative complications (grade III-V) were reported in five patients (22.7%), including one mortality patient. The median overall survival since diagnosis with metastasis was 27.4 months. The median overall survival since surgical intervention and the progression-free survival were 16.7 months and 7.1 months, respectively.

Conclusions: This short-term follow-up study showed that, in an experienced center, combined resection with hyperthermic intraperitoneal chemotherapy for colorectal liver and peritoneal metastases was feasible and safe with acceptable oncologic outcomes.

Keywords: Colorectal cancer; Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Liver metastases; Liver resection; Peritoneal metastases.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • Colorectal Neoplasms / therapy*
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures / methods
  • Female
  • Hepatectomy / methods
  • Humans
  • Hyperthermia, Induced / methods*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary / drug therapy
  • Neoplasms, Multiple Primary / pathology
  • Neoplasms, Multiple Primary / surgery
  • Neoplasms, Multiple Primary / therapy*
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery
  • Peritoneal Neoplasms / therapy*
  • Prognosis
  • Retrospective Studies
  • Survival Rate