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TITULO: MULTIMODALITY TREATMENT COMBINING CHEMOTHERAPY, LIVER SURGERY, PERITONEAL RESECTION AND HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY (HIPEC) FOR METASTATIC COLORECTAL CANCER (MCRC) PATIENTS WITH SYNCHRONOUS LIVER METASTASES (LM) AND PERITONEAL CARCINOMATOSIS
AUTORES: Rea Lo Dico, Rea Lo Dico, Eveno Clarisse, Marc Pocard
Nº DE REFERENCIA 11553
TIPO PRESENTACION: Temas Libres
CATEGORIA: Coloproctología
RESUMEN DE LA PRESENTACION:
ANTECEDENTES: Patients with synchronous Peritoneal Carcinomatosis and Liver Metastases are generally considered for exclusive systemic palliative chemotherapy only. Aggressive surgical approaches combining hepatectomy associated to peritoneal resection with curative intent remain controversial in such a setting and almost no data are available on such patients.
OBJETIVO: The aim of this prospective cohort was to assess morbidity, mortality, disease-free survival (DFS) and overall survival (OS) of peritoneal and liver mCRC patients (pts) treated with an aggressive therapeutic approach combining surgical treatment of liver and peritoneal lesions followed by HIPEC.
DISEÑO: --
MATERIAL Y METODO: All patients registered in the French Association of Surgery prospective database with PC and synchronous LM who had undergone cytoreductive surgery and LM resection followed by intraperitoneal chemotherapy were analysed. The primary endpoint was survival from the time of surgery. The following criteria were recorded and analyzed: sex, age, differentiation and localization of the primary tumor, lymph node involvement (pN+), peritoneal cancer index (PCI), completeness of cytoreduction of peritoneal carcinomatosis, number of associated liver metastases.
RESULTADOS: From 1993 to 2011, 101 pts with PC and LM were analyzed. After a mean follow-up of 25 months, the median OS and DFS, were respectively 24.9 and 9.5 months. Post- operative morbidity and mortality was 14.8 and 0%, respectively. In pts with a complete cytoreductive surgery OS was 29 months (n=), as compared to 4 months in pts (n=) with incomplete cytoreduction (p=0.0001). Rectal primary tumor, PCI of 13 or more, pN+ status, and more than 3 LM were not identified as independent factors for poor OS.
CONCLUSIONES: This multicenter study confirms that prolonged survival can be achieved in selected patients suitable for PC and LM surgery if they underwent multimodality treatment including surgical treatment of PC and LM with curative intent, using intraperitoneal chemotherapy.
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