Secondary Cytoreductive Surgery ± Hyperthermic Intraperitoneal Chemotherapy for Recurrent Colorectal Cancer...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Colorectal cancer peritoneal metastases (CRC-PM) frequently recur within a year after initial cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS±HIPEC).
• Evaluating the safety and effectiveness of secondary CRS±HIPEC is crucial for managing recurrent CRC-PM.

Purpose of the Study:

• To assess the safety of secondary CRS±HIPEC in patients with CRC-PM.
• To determine the oncologic value, specifically overall survival (OS), associated with secondary CRS±HIPEC.

Main Methods:

• A multi-institutional database (2000-2024) was retrospectively reviewed.
• Patients undergoing initial CRS±HIPEC were compared with those receiving secondary CRS±HIPEC for recurrent disease.
• Perioperative outcomes and overall survival were analyzed.

Main Results:

• No significant difference in postoperative complications was observed between initial and secondary CRS±HIPEC.
• Secondary CRS±HIPEC was associated with improved OS when measured from the initial operation date (51.0 months vs. 24.0 months).
• When measured from the secondary procedure, OS was similar to initial CRS±HIPEC, but secondary CRS±HIPEC improved OS compared to single procedures in recurrent cases.

Conclusions:

• Secondary CRS±HIPEC is a safe procedure for managing recurrent CRC-PM.
• This treatment should be considered for well-selected patients experiencing recurrence after initial CRS±HIPEC.