International Journal of Colorectal Disease

, Volume 22, Issue 11, pp 1295–1300 | Cite as

Multimodality treatment of peritoneal carcinomatosis from colorectal cancer: first results of a new German centre for peritoneal surface malignancies

  • P. Piso
  • M. H. Dahlke
  • N. Ghali
  • I. Iesalnieks
  • M. Loss
  • F. Popp
  • P. von Breitenbuch
  • A. Agha
  • S. A. Lang
  • F. Kullmann
  • H. J. Schlitt
Original Article

Abstract

Background

The presence of peritoneal carcinomatosis arising from colorectal cancer is associated with a poor prognosis. It was the purpose of this study to analyze morbidity, mortality, and survival after major cytoreductive surgery and intraperitoneal chemotherapy.

Materials and methods

Thirty-two patients with peritoneal carcinomatosis were operated between April 2004 and June 2006 with the aim of complete macroscopical cytoreduction. All had a primary colorectal carcinoma. Surgery in these patients was followed by hyperthermic intraperitoneal chemotherapy (HIPEC) consisting of mitomycin C and doxorubicin. Data were analyzed retrospectively.

Results

Of all patients, 16 had appendix and 16 non-appendiceal colorectal carcinoma. A macroscopically complete cytoreduction was achieved in 24 patients by parietal and visceral peritonectomy procedures. All resections were combined with HIPEC. Overall morbidity was 34%. Most frequent surgical complications were intestinal obstruction (4/32), enteric fistula (2/32), pancreatitis (2/32), and bile leakage (2/32). One patient presented grade 4 renal toxicity. There was no hospital mortality. The median follow-up was 12 months. The 1-year overall survival rate is 96%. All patients after complete cytoreduction are still alive.

Conclusions

Cytoreductive surgery combined with HIPEC is associated with an acceptable morbidity and low mortality. Complete cytoreduction may improve survival, particularly in well-selected patients having a low tumor volume and no extra-abdominal metastases.

Keywords

Peritoneal carcinomatosis 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • P. Piso
    • 1
    • 3
  • M. H. Dahlke
    • 1
  • N. Ghali
    • 1
  • I. Iesalnieks
    • 1
  • M. Loss
    • 1
  • F. Popp
    • 1
  • P. von Breitenbuch
    • 1
  • A. Agha
    • 1
  • S. A. Lang
    • 1
  • F. Kullmann
    • 2
  • H. J. Schlitt
    • 1
  1. 1.Department of SurgeryUniversity of RegensburgRegensburgGermany
  2. 2.Department of Internal Medicine IUniversity of RegensburgRegensburgGermany
  3. 3.Klinik und Poliklinik für ChirurgieKlinikum der Universität RegensburgRegensburgGermany

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