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The Treatment of Peritoneal Carcinomatosis of Colorectal Cancer with Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Peroperative Chemotherapy (HIPEC) with Oxaliplatin: A Belgian Multicentre Prospective Phase II Clinical Study

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Up to 25% of patients with metastatic colorectal cancer (CRC) present with peritoneal carcinomatosis (PC) as the only site of metastases. Complete cytoreductive surgery (CCRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) aims for locoregional disease control and long-term survival. Oxaliplatin is effective for treating advanced CRC. This study assesses the safety and efficacy of CCRS with HIPEC with oxaliplatin for patients with PC of CRC.

Methods

A Belgian prospective multicenter registry was performed to monitor perioperative morbidity and assess mortality, disease-free survival (DFS), and overall survival (OS).

Results

Forty-eight consecutive patients underwent CCRS (R0/1) with HIPEC (male/female ratio 17/31, median age 60 years, range 24–76 years). Median PC index was 11 (range 1–22). Median operation time was 460 (range 125–840) min, with a median blood loss of 475 (range 2–6,000) ml. Thirty-day mortality was 0%. Complication rate (any grade) was 52.1%. Anastomotic leakage occurred in 10.4% of patients, bleeding in 6.3%, and bowel perforation in 2.1%. Median hospital stay was 20 (range 5–65) days. At median follow-up of 22.7 (range 3.2–55.7) months, OS was 97.9% [95% confidence interval (CI) 86.1–99.7] at 1 year and 88.7% (95% CI 73.6–95.4) at 2 years. DFS at 1 year was 65.8% (95% CI 52.3–76.2) and 45.5% (95% CI 34.3–55.9) at 2 years. Median time until recurrence was 19.8 months (95% CI 12–upper limit not defined). Only after dichotomizing PC index was a significant difference in OS found between low and high PC index.

Conclusions

CCRS followed by HIPEC with oxaliplatin for PC from CRC can be implemented with acceptable morbidity. Long-term DFS and OS can be achieved in selected patients.

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Acknowledgment

This study was supported by a research grant from Sanofi-Aventis.

Author information

Authors and Affiliations

  1. Department of Abdominal Surgery, University Hospitals Gasthuisberg, Leuven, Belgium

    Daphne Hompes MD & André D’Hoore MD, PhD

  2. Department of Digestive Oncology, University Hospitals Gasthuisberg, Leuven, Belgium

    Eric Van Cutsem MD, PhD

  3. I-Biostat, Katholieke Universiteit Leuven and Universiteit Hasselt, Leuven, Belgium

    Steffen Fieuws PhD

  4. Department of Abdominal Surgery, University Hospital Ghent, Ghent, Belgium

    Wim Ceelen MD, PhD

  5. Department of Digestive Oncology, University Hospital Ghent, Ghent, Belgium

    Marc Peeters MD, PhD

  6. Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium

    Kurt Van der Speeten MD, PhD

  7. Department of Abdominal Surgery, Hopital de Jolimont, Jolimont, Belgium

    Claude Bertrand MD

  8. Department of Digestive Oncology, UCL Mont-Godinne, Yvoir, Belgium

    Hugues Legendre MD

  9. Department of Abdominal Surgery, UCL Mont-Godinne, Yvoir, Belgium

    Joseph Kerger MD

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  1. Daphne Hompes MD
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  2. André D’Hoore MD, PhD
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Correspondence to Daphne Hompes MD.

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Hompes, D., D’Hoore, A., Van Cutsem, E. et al. The Treatment of Peritoneal Carcinomatosis of Colorectal Cancer with Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Peroperative Chemotherapy (HIPEC) with Oxaliplatin: A Belgian Multicentre Prospective Phase II Clinical Study. Ann Surg Oncol 19, 2186–2194 (2012). https://doi.org/10.1245/s10434-012-2264-z

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  • DOI: https://doi.org/10.1245/s10434-012-2264-z

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