Abstract
Purpose
The liver and peritoneum are common sites of colorectal metastases. Hepatectomy for colorectal liver metastases (CLM) is considered gold standard treatment. We attempt to compare the survival outcomes for CLM patients after hepatectomy to that of patients with colorectal peritoneal metastases (CPM) who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods
A retrospective review of patients with CPM and CLM who underwent surgery between January 2003 and May 2011 was performed. The overall (OS) and disease-free survivals (DFS) were compared.
Results
There were 22 patients with CPM who underwent CRS and HIPEC and 186 patients who underwent hepatectomy for CLM. Patients with CPM had a 3-year OS of 39 % and DFS of 27.7 %. CLM patients showed a 3-year OS of 58.5 % and a DFS of 28.8 %. Most recurrences for CPM occurred within 2 years, while CLM patients continue to develop systemic recurrences over 3 years, showing a gradual decline in DFS and OS during this period of time.
Conclusion
Our results show that CRS and HIPEC for CPM confer good OS and DFS rates and that the DFS after CRS and HIPEC is comparable to that after hepatectomy for CLM.
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References
American Cancer Society. Cancer facts and figures 2012. http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2012.
Grundmann RT. Current state of surgical treatment of liver metastases from colorectal cancer. World J Gastrointest Surg. 2011;3(12):183–96.
Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg. 1995;19:59–71.
Jamison RL, Donohue JH, Nagorney DM, Rosen CB, Harmsen WS, Ilstrup DM. Hepatic resection for metastatic colorectal cancer results in cure for some patients. Arch Surg. 1997;132:505–10.
Choti MA, Sitzmann JV, Tiburi MF, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg. 2002;235:759–66.
Rees M, Tekkis PP, Welsh FK, O'Rourke T, John TG. Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg. 2008;247:125–35.
Shen P, Thai K, Stewart JH, Howerton R, Loggie BW, Russell GB, Levine EA. Peritoneal surface disease from colorectal cancer: comparison with the hepatic metastases surgical paradigm in optimally resected patients. Ann Surg Oncol. 2008;15:3422–32.
Cao CQ, Yan TD, Liauw W, Morris DL. Comparison of optimally resected hepatectomy and peritonectomy patients with colorectal cancer metastasis. J Surg Oncol. 2009;100(7):529–33.
Sugarbaker PH. Peritonectomy procedures. Ann Surg. 1995;221:29–42.
Morgan RJJ, Synold TW, Xi B, et al. Phase I trial of intraperitoneal gemcitabine in the treatment of advanced malignancies primarily confined to the peritoneal cavity. Clin Cancer Res. 2007;13:1232–7.
Witkamp AJ, de Bree E, Van Goethem R, Zoetmulder FA. Rationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapy. Cancer Treat Rev. 2001;27(6):365–74.
Wagner PL, Jones D, Aronova A, et al. Early postoperative intraperitoneal chemotherapy following cytoreductive surgery for appendiceal mucinous neoplasms with isolated peritoneal metastasis. Dis Colon Rectum. 2012;55(4):407–15.
Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Peritoneal Carcinomatosis: Principles of Management. Boston: Kluwer; 1996. p. 359–74.
Sugarbaker PH, Jablonsky KA. Prognostic features of 51 colorectal and 130 appendiceal cancer patients with peritoneal carcinomatosis treated by cytoreductive surgery and intraperitoneal chemotherapy. Ann Surg. 1995;221:124–32.
Sugarbaker PH, Ronnett BM, Archer A, et al. Pseudomyoxma peritonei syndrome. Adv Surg. 1997;30:233–80.
Sugarbaker PH. Successful management of microscopic residual disease in large bowel cancer. Cancer Chemother Pharmacol. 1999;43(Suppl):S15–25.
Glehen O, Kwiatkowski F, Sugarbaker PH, et al. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol. 2004;22:3284–92.
Verwaal VJ, van Ruth S, de Bree E, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003;21:3737–43.
Verwaal VJ, Bruin S, Boot H, et al. 8-Year follow-up of randomized trials: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol. 2008;15(9):2426–32.
Lopez P, Marzano E, Piardi T, Pessaux P. Repeat hepatectomy for liver metastases from colorectal primary cancer: a review of the literature. J Visc Surg. 2012 Feb 6 (EPub).
Choti MA, Bowman HM, Pitt HA, Sosa JA, Sitzmann JV, Cameron JL, Gordon TA. Should hepatic resections be performed at high-volume referral centers? J Gastro Surg. 1998;2(1):11–210.
da Silva RG, Sugarbaker PH. Analysis of prognostic factors in seventy patients having a complete cytoreduction plus perioperative intraperitoneal chemotherapy for carcinomatosis from colorectal cancer. J Am Coll Surg. 2006;203(6):878–86.
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Tan, G.H.C., Teo, M.C.C., Chen, W. et al. Surgical Management of Colorectal Peritoneal Metastases: Treatment and Outcomes Compared with Hepatic Metastases. J Gastrointest Canc 44, 170–176 (2013). https://doi.org/10.1007/s12029-012-9452-8
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DOI: https://doi.org/10.1007/s12029-012-9452-8