|Reference : Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Perit...|
|Scientific journals : Article|
|Human health sciences : Surgery|
|Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Peritoneal Carcinomatosis : Higher Complication Rate for Oxaliplatin Compared to Mitomycin C|
|Rouers, A. [> >]|
|Laurent, S. [> >]|
|Detroz, Bernard [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie abdominale- endocrinienne et de transplantation >]|
|Meurisse, Michel [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie abdominale- endocrinienne et de transplantation >]|
|Acta Chirurgica Belgica|
|Acta Medica Belgica|
|[en] Cytoreductive surgery ; hyperthermic intraperitoneal chemotherapy ; peritoneal carcinomatosis|
|[fr] colorectal cancer ; oxaliplatin ; mitomycin C.|
|[en] Peritoneal carcinomatosis (PC) from colo-rectal cancer carries a very poor prognosis with a
mean and median overall survival times of 6.9 and 5.2 months. It has been proved that a locoregional therapeutic
approach of this disease with cytoreduction followed by hyperthermic intraperitoneal chemotherapy (HIPEC) improved
survival of these patients. However, this combined treatment presents a high complication rate.
Methods : 21 patients with PC of colorectal origin underwent complete cytoreduction followed by HIPEC using
Mitomycin-C (13 patients) or oxaliplatin (8 patients) and the open coliseum technique. For each case the medical datas
were retrospectively analysed to determine feasibility, morbidity, mortality, survival time and prognostic factors.
Results : All patients presented a Sugarbaker’s Peritoneal Cancer index inferior to 15. The mean operating time was
453 minutes. After a median follow-up of 24.9 months, actuarial disease-free survival was 36.6% at 5 years. The median
survival time was 34 months. The morbidity rate was 33.3% with a significant higher complication rate in the oxaliplatin
group (5/8) than in the Mytomycin-C (MMC) group (2/13). One patient (4.7%) died two months after treatment
with MMC (endocarditis).
Conclusions : This series confirm positive impact of cytoreduction and HIPEC on PC. We obtained a moderated
complications rate thanks to a high degree of selection of the patient. Oxaliplatin scheme is responsible of a higher
morbidity than in MMC group. Phase III trial comparing these two drugs is needed.
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