Skip to main content

Advertisement

SpringerLink
Log in

Failure Analysis of Recurrent Disease Following Complete Cytoreduction and Perioperative Intraperitoneal Chemotherapy in Patients with Peritoneal Carcinomatosis from Colorectal Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to analyze the anatomic distribution, timing, and outcomes of recurrent disease after complete cytoreduction and perioperative intraperitoneal chemotherapy (PIC) for peritoneal carcinomatosis of colorectal origin.

Methods

Data regarding all patients who underwent complete cytoreduction and PIC for carcinomatosis from colorectal cancer were extracted from a prospectively collected database. The information regarding recurrent disease found on diagnostic evaluation and/or abdominal exploration was analyzed.

Results

Seventy patients underwent complete cytoreduction and perioperative intraperitoneal chemotherapy, and 49 of them had documented recurrent disease. The median time to progression for these 49 patients was 9 months while their median survival was 30 months. Eighteen patients had a localized intra-abdominal recurrence, 10 had diffuse intraperitoneal recurrence, 10 had isolated distant metastases, and 11 had a combination of distant metastases and intra-abdominal recurrence. There was a statistically significant difference in survival for patients with different patterns of recurrence (P = .012). Twenty-six patients underwent a second operation. The median survival of these patients was significantly longer than that of patients who did not have a second operation (39 vs 20 months, P = .0003). Four of the 49 patients with recurrences were still alive at the time of last follow-up, and three of them have no evidence of disease 73, 96, and 206 months after the diagnosis of recurrence.

Conclusions

Recurrence is a frequent event after optimal cytoreduction and PIC for carcinomatosis from colorectal cancer. Surgical treatment for a selected group of patients with recurrent disease may result in long-term survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIG. 1.
FIG. 2.
FIG. 3.
FIG. 4.

Similar content being viewed by others

REFERENCES

  1. Jayne DG, Fook S, Loi C, Seow-Choen F. (2002) Peritoneal carcinomatosis from colorectal cancer. Br J Surg 89:1545–50

    Article  PubMed  CAS  Google Scholar 

  2. Sadeghi B, Arvieux C, Glehen O, et al. (2000) Peritoneal carcinomatosis from non-gynecologic malignancies. Cancer 88(2):358–63

    Article  PubMed  CAS  Google Scholar 

  3. Chu DZ, Lang NP, Thompson C, Osteen PK, Westbrook KC. (1989) Peritoneal carcinomatosis in nongynecologic malignancy. Cancer 63:364–7

    Article  PubMed  CAS  Google Scholar 

  4. Goldberg RM, Sargent DJ, Morton RF, et al. (2004) A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 22:23–30

    Article  PubMed  CAS  Google Scholar 

  5. Hurwitz H, Fehrenbacher L, Novotny W, et al. (2004) Bevacizumab plus irinotecan, fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–42

    Article  PubMed  CAS  Google Scholar 

  6. Taieb J, Artru P, Paye F, et al. (2005) Intensive systemic chemotherapy combined with surgery for metastatic colorectal cancer: results of a phase II study. J Clin Oncol 23:502–9

    Article  PubMed  CAS  Google Scholar 

  7. Glehen O, Kwiatkowski F, Sugarbaker PH, et al. (2004) Cytoreductive surgery with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol 22(16):3284–92

    Article  PubMed  CAS  Google Scholar 

  8. Mahteme H, Hansson J, Berglund, Pahlman L. Glimelius B. Nygren P. Graf W. (2004) Improved survival in patients with peritoneal metastases from colorectal cancer: a preliminary study. Br J Cancer 90:403–7

  9. Elias D, Sideris L, Pocard M, et al. (2004) Efficacy of intraperitoneal chemohyperthermia with oxaliplatin in colorectal peritoneal carcinomatosis. Preliminary results in 24 patients. Ann Oncol 15:781–5

    Article  PubMed  CAS  Google Scholar 

  10. Gomes da Silva RG, Sugarbaker PH. (2006) Analysis of 10 prognostic factors in 70 patients having complete cytoreduction plus perioperative intraperitoneal chemotherapy for carcinomatosis from colorectal cancer. J Am Coll Surg 203(6):878–86

    Article  Google Scholar 

  11. Yan TD, Black D, Savady R, Sugarbaker PH. (2006) Systematic review on the efficacy of cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal carcinoma. J Clin Oncol 24(24):4011–9

    Article  PubMed  Google Scholar 

  12. Verwaal VJ, van Ruth S, Witkamp A, Boot H, van Slooten G, Zoetmulder FAN. (2005) Long-term survival of peritoneal carcinomatosis of colorectal origin. Ann Surg Oncol 12(1):65–71

    Article  PubMed  Google Scholar 

  13. Verwaal VJ, Boot H, Aleman BMP, van Tinteren H, Zoetmulder FAN. (2003) Recurrences after peritoneal carcinomatosis of colorectal origin treated by cytoreduction and hyperthermic intraperitoneal chemotherapy: location, treatment and outcome. Ann Surg Oncol 11(4):375–9

    Article  Google Scholar 

  14. Sugarbaker PH. (1995) Peritonectomy procedures. Ann Surg 221:29–42

    Article  PubMed  CAS  Google Scholar 

  15. Yan TD, Chu F, Links M, Kam PC, Glenn D, Morris DL. (2006) Cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal carcinoma: non-mucinous tumour associated with an improved survival. Eur J Surg Oncol 32(10):1119–24

    Article  PubMed  CAS  Google Scholar 

  16. Verwaal VJ, van Ruth S, de Bree E, van Slooten GW, van Tinteren H, Boot H, Zoetmulder FAN. (2003) Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal origin. J Clin Oncol 21:3737–43

    Article  PubMed  Google Scholar 

  17. Portilla AG, Sugarbaker PH, Chang D. (1999) Second-look surgery after cytoreduction and intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer: analysis of prognostic features. World J Surg 23:23–9

    Article  PubMed  CAS  Google Scholar 

Download references

ACKNOWLEDGMENT

Supported in part by FARGO (Foundation for Applied Research in Gastrointestinal Oncology).

Author information

Authors and Affiliations

  1. Washington Cancer Institute, Washington Hospital Center, Washington, DC, USA

    Lana Bijelic MD, Tristan D. Yan BSc (Med) MBBS & Paul H. Sugarbaker MD, FACS, FRCS

Authors
  1. Lana Bijelic MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tristan D. Yan BSc (Med) MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul H. Sugarbaker MD, FACS, FRCS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul H. Sugarbaker MD, FACS, FRCS.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bijelic, L., Yan, T.D. & Sugarbaker, P.H. Failure Analysis of Recurrent Disease Following Complete Cytoreduction and Perioperative Intraperitoneal Chemotherapy in Patients with Peritoneal Carcinomatosis from Colorectal Cancer. Ann Surg Oncol 14, 2281–2288 (2007). https://doi.org/10.1245/s10434-007-9410-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-007-9410-z

Keywords

Search

Navigation