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. 2014 Sep 9;111(6):1112-21.
doi: 10.1038/bjc.2014.369. Epub 2014 Jul 15.

Intraperitoneal chemotherapy as adjuvant treatment to prevent peritoneal carcinomatosis of colorectal cancer origin: a systematic review

D A M Sloothaak  1 , B Mirck  1 , C J A Punt  2 , W A Bemelman  1 , J D W van der Bilt  3 , A D'Hoore  3 , P J Tanis  1
Affiliations

Intraperitoneal chemotherapy as adjuvant treatment to prevent peritoneal carcinomatosis of colorectal cancer origin: a systematic review

D A M Sloothaak et al. Br J Cancer. .

Abstract

Background: Peritoneal carcinomatosis (PC) of colorectal cancer (CRC) origin is associated with poor outcome. This systematic review evaluates the available evidence about adjuvant (hyperthermic) intraperitoneal chemotherapy ((H)IPEC) to prevent the development of PC.

Methods: A systematic search of literature was conducted in August 2013 in PubMed, Embase, and the Cochrane database for studies on (H)IPEC to prevent PC in patients who underwent curative surgery for primary CRC.

Results: Seven comparative studies and five cohort studies were selected. Treatment schedules varied between repeated fluoropyrimidine-based IPEC administration in the ambulatory setting to intra-operative (H)IPEC procedures using mitomycin-C or oxaliplatin. The reported rates of major complications related to adjuvant (H)IPEC was low. Four out of five evaluable comparative studies reported a significant difference in the incidence of PC in favour of (H)IPEC. All three comparative studies reporting on survival after intra-operative (H)IPEC showed a significant survival benefit in favour of the experimental arm. Substantial heterogeneity in patient selection, treatment protocols, and treatment effect evaluation among studies was observed.

Conclusions: The currently available evidence about adjuvant (H)IPEC in high-risk CRC is limited and subject to bias, but points towards improved oncological outcome and supports further randomised studies.

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Figures

Figure 1
Figure 1
Flow chart of systematic search.
See this image and copyright information in PMC

References

    1. Andre T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, Bonetti A, Clingan P, Bridgewater J, Rivera F, de Gramont A. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27 (19:3109–3116. - PubMed
    1. Brodsky JT, Cohen AM. Peritoneal seeding following potentially curative resection of colonic carcinoma: implications for adjuvant therapy. Dis Colon Rectum. 1991;34 (8:723–727. - PubMed
    1. Catalano V, Loupakis F, Graziano F, Torresi U, Bisonni R, Mari D, Fornaro L, Baldelli AM, Giordani P, Rossi D, Alessandroni P, Giustini L, Silva RR, Falcone A, D'Emidio S, Fedeli SL. Mucinous histology predicts for poor response rate and overall survival of patients with colorectal cancer and treated with first-line oxaliplatin- and/or irinotecan-based chemotherapy. Br J Cancer. 2009;100 (6:881–887. - PMC - PubMed
    1. Chouillard E, Ata T, De JB, Maggiori L, Helmy N, Coscas Y, Outin H. Staged laparoscopic adjuvant intraperitoneal chemohyperthermia after complete resection for locally advanced colorectal or gastric cancer: a preliminary experience. Surg Endosc. 2009;23 (2:363–369. - PubMed
    1. Chu DZ, Lang NP, Thompson C, Osteen PK, Westbrook KC. Peritoneal carcinomatosis in nongynecologic malignancy. A prospective study of prognostic factors. Cancer. 1989;63 (2:364–367. - PubMed

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