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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(02): 107-114
DOI: 10.1055/s-0041-1740472
Original Article

Predictors of Recurrence of Peritoneal Carcinomatosis among Patients with Colorectal Cancer Following Cytoreductive Surgery alone versus Cytoreductive Surgery Plus HIPEC

Waheed Yousry Gareer
1   Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Gamal Amira Mohamed
1   Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Mohamed H. Zedan
1   Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Tarek Sherif Al Baradei
1   Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Shaimaa Abdalaleem Abdalgeleel 
2   Department of Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo, Egypt
,
Sherif Mohamed Khairallah 
1   Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
› Author Affiliations Funding The present research was funded by the authors.
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Abstract

Background Peritoneal carcinomatosis (PC) is a lethal regional progression in patients with colorectal cancer (CRC). Treatment with complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) achieves better local control than systemic palliative chemotherapy.

Objectives To assess the efficacy on the prognosis of CRS and HIPEC compared with CRS only and to identify possible clinicopathological factors associated with the recurrence of PC.

Methods The present retrospective study included all colorectal carcinoma cases with PC subjected to CRS with or without HIPC from January 2009 to June 2018 at the National Cancer Institute (NCI), Cairo University, Cairo, Egypt. The outcome is evaluated in terms of recurrence-free survival (RFS) and its predictors.

Results Out of the 61 patients, 45 patients (73.8%) underwent CRS plus HIPEC, and 16 (26.2%) underwent CRS alone. The 1-year RFS was 55.7%, with a median of 12 months. The risk factors for recurrence identified in the univariate analysis were T4 primary tumor, high-grade, positive lymphovascular invasion (LVI), positive extracapsular nodal spread, and patients treated with CRS only, without HIPEC. In the multivariate analysis, the independent risk factors for recurrence were high grade and patients treated with CRS only.

Conclusion T4 primary tumor, high grade, positive LVI, and positive extracapsular nodal spread seemed to be important predictors of recurrence following the treatment of PC. Our study also demonstrated that the addition of HIPEC to CRS improved the RFS.

Keywords

colorectal cancer - peritoneal carcinomatosis - cytoreductive surgery - HIPEC

Ethical Issues

Approval by the Institutional Review Board of the National Cancer Institute was obtained before the start of the present study (IRB Number: IRB00004025, approval number: 201819016.3).




Publication History

Received: 01 April 2021

Accepted: 13 August 2021

Article published online:
15 June 2022

© 2022. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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