, Volume 14, Issue 7, pp 2171-2172
Date: 24 Apr 2007

An Evolving Role of Perioperative Intraperitoneal Chemotherapy After Cytoreductive Surgery for Colorectal Peritoneal Carcinomatosis

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We read with interest the recent article by Elias et al. that compared hyperthermic intraperitoneal chemotherapy (HIPEC) with early postoperative intraperitoneal chemotherapy (EPIC) after complete cytoreductive surgery for colorectal peritoneal carcinomatosis.1 The authors demonstrated that there was a reduced peritoneal recurrence rate in the HIPEC group (6 of 23) as compared with the EPIC group (13 of 23), but this did not translate into a statistically significant difference in survival (P = .22). This absence of a difference in survival probably occurred because the total numbers of patients who had disease recurrence, including both peritoneal and systemic, were equal in the two comparative groups (18 of 23). But this said, the 5-year survival of 54% in the HIPEC group and 28% in the EPIC group did indicate that there was a trend of difference. The results are particularly promising when we consider that 38% of the total patients had synchronous liver metastases and 48% had positi