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Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy still beneficial in patients diagnosed with colorectal peritoneal metastasis who underwent palliative chemotherapy?

Authors
 Hye Jung Cho  ;  Jong Woo Kim  ;  Woo Ram Kim 
Citation
 ASIAN JOURNAL OF SURGERY, Vol.47(1) : 296-302, 2024-01 
Journal Title
ASIAN JOURNAL OF SURGERY
ISSN
 1015-9584 
Issue Date
2024-01
MeSH
Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Chemotherapy, Cancer, Regional Perfusion ; Colorectal Neoplasms* / pathology ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced* ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms* / secondary ; Peritoneal Neoplasms* / therapy ; Retrospective Studies ; Survival Rate
Keywords
Colorectal neoplasm ; Cytoreductive surgery ; Intraperitoneal chemotherapy ; Peritoneal carcinomatosis
Abstract
Background
With a 5-year overall survival of less than 5%, colorectal peritoneal metastasis (CPM) patients are often managed with palliative chemotherapy (CTx). In the past few decades, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been introduced as a possible curative treatment for highly selective CPM patients. We share our experience of CRS and HIPEC given the unique characteristics of the medical system and the benefit of CRS and HIPEC in palliative setting.

Methods
From April 2017 to October 2021, CPM patients who underwent CRS and HIPEC were analyzed. Patients were allocated into perioperative and palliative CTx arm based on the duration between initial diagnosis of CPM to undergoing CRS and HIPEC of 6 months. Data including perioperative parameters, postoperative outcomes, and survival were analyzed with a median follow-up of 28.5 months.

Results
Twenty-six CPM patients underwent CRS and HIPEC. Mean time from diagnosis of CPM to CRS and HIPEC was 5.5 months with 14 patients in the perioperative arm and 12 patients in the palliative arm. Perioperative group showed a longer RFS of 13.5 months compared to 8 months in the palliative group. Median overall survival of palliative group was 41.50 months, and 18 patients among all groups are alive at the time of this report.

Conclusion
CRS and HIPEC could be a treatment option for a carefully selected CPM patients performed by experienced surgeons. Overall survival of 41.50 months in palliative group compared to 16.8 months from conventional systemic CTx supports CRS and HIPEC even in palliative patients.
Files in This Item:
T202307548.pdf Download
DOI
10.1016/j.asjsur.2023.08.135
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Woo Ram(김우람)
Cho, Hye Jung(조혜정)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198147
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