Advertisement

Pilot study of adjuvant hyperthermic intraperitoneal chemotherapy in patients with colorectal cancer at high risk for the development of peritoneal metastases

Abstract

Aims and background. The prognosis of peritoneal metastases from colorectal cancer has recently improved with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Although outcomes are further improved when early stage peritoneal metastases are treated, adjuvant hyperthermic intraperitoneal chemotherapy has never been thoroughly addressed. This prospective pilot study assessed feasibility, safety and efficacy of hyperthermic intraperitoneal chemotherapy combined with primary curative surgery in colorectal cancer at high risk for peritoneal metastases.
Methods. Twelve patients were prospectively selected according to predetermined risk factors for the development of peritoneal metastases. Patients underwent conventional colon surgery, closed-abdomen mitomycin-C plus cisplatin-based hyperthermic intraperitoneal chemotherapy, and cytoreductive surgical procedures, as needed.
Results. Preoperative tumor-related risk factors were confirmed by intraoperative findings and pathological examination in all patients: minimal synchronous peritoneal metastases (n = 2), synchronous ovarian metastases (n = 1), positive peritoneal washing cytology (n = 2), primary tumor directly invading other organs (n = 6), or penetrating visceral peritoneum (n = 1). Major morbidity occurred in 2 patients and operative death in none. Median follow-up was 49 months (range, 22-72). Peritoneal metastases occurred in 1 patient and distant metastases in 2. Five-year overall survival was 83.3%.
Conclusions. Preoperative/early intraoperative assessment can reliably identify colorectal cancer patients at high risk for peritoneal metastases. Adjuvant hyperthermic intraperitoneal chemotherapy is well tolerated and safe. These preliminary results would support the design of future phase-III trials of adjuvant hyperthermic intraperitoneal chemotherapy.

Tumori 2013; 99(5): 589 - 595

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.1700/1377.15307

Authors

Salvatore Virzì, Domenico Iusco, Dario Baratti, Serena Bonomi, Antonio Grassi, Shigeki Kusamura, Marcello Deraco

Article History

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.

Authors

  • Virzì, Salvatore [PubMed] [Google Scholar]
    General Surgery Unit, Bentivoglio Hospital, AUSL Bologna, Bentivoglio (BO), Italy
  • Iusco, Domenico [PubMed] [Google Scholar]
    General Surgery Unit, Bentivoglio Hospital, AUSL Bologna, Bentivoglio (BO), Italy
  • Baratti, Dario [PubMed] [Google Scholar]
    Peritoneal Surface Malignancy Program, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
  • Bonomi, Serena [PubMed] [Google Scholar]
    General Surgery Unit, Bentivoglio Hospital, AUSL Bologna, Bentivoglio (BO), Italy
  • Grassi, Antonio [PubMed] [Google Scholar]
    General Surgery Unit, Bentivoglio Hospital, AUSL Bologna, Bentivoglio (BO), Italy
  • Kusamura, Shigeki [PubMed] [Google Scholar]
    Peritoneal Surface Malignancy Program, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
  • Deraco, Marcello [PubMed] [Google Scholar]
    Peritoneal Surface Malignancy Program, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.