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Long-term follow-up in the treatment of peritoneal carcinomatosis
Trevor Hamilton1, Kathryn Lanuke, Lloyd A Mack
1Department of Surgery, University of Calgary, Calgary, AB, Canada.
Background:
The objective of this study was to report a long-term survival analysis of a phase II protocol of cytoreductive surgery (CS) and heated intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal carcinomatosis (PCs).
Methods:
Between 2000 and 2008, 101 consecutive patients were treated with CS, HIPEC and early postoperative intraperitoneal chemotherapy using a standardized protocol. Disease recurrence and mortality data were collected prospectively. Primary outcomes were median, 3-year, and 5-year disease-free survival (DFS) and overall survival (OS).
Results:
The median age was 49 years (range, 18-77 years), and the majority (82%) had complete CS with no gross residual cancer. Tumor types included appendiceal (n = 58), colorectal (n = 31), and other (n = 12). Median follow-up was 28 months (range, 0-119 months), with minimum of 24 months among survivors. For appendiceal tumors, median DFS was 34 months (range, 0-119 months) and OS has not yet been defined. Three-year and 5-year DFS was 48% and 42%, respectively, and 3-year and 5-year OS was 76% and 62%, respectively. For colorectal carcinomatosis, median disease-free and OS was 9 months (range, 0-87 months) and 27 months (range, 0-87 months), respectively. Three-year and 5-year DFS was 34% and 26%, respectively, and 3-year and 5-year OS was 38% and 34%, respectively.
Conclusions:
Long-term survival with regional treatment of PC from appendiceal or colorectal primary tumors with CS and HIPEC is achievable.