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. 2018 Mar 27;16(1):70.
doi: 10.1186/s12957-018-1369-7.

Treatment of intraoperatively detected peritoneal carcinomatosis of colorectal origin with cytoreductive surgery and intraperitoneal chemotherapy

Aras Emre Canda  1 , Cigdem Arslan  2 , Cem Terzi  2 , Selman Sokmen  2 , Tugba Yavuzsen  3 , Sevda Ozkardesler  4 , Mehtat Unlu  5 , Funda Obuz  6 , Mehmet Fuzun  2
Affiliations

Treatment of intraoperatively detected peritoneal carcinomatosis of colorectal origin with cytoreductive surgery and intraperitoneal chemotherapy

Aras Emre Canda et al. World J Surg Oncol. .

Abstract

Background: Diagnosis of peritoneal carcinomatosis (PC) may be missed by preoperative imaging. We are presenting our experience with incidentally detected PC of colorectal origin treated with cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) at the same operation.

Methods: Between January 2010 and September 2016, 19 patients underwent CRS and IPC due to incidentally detected PC of colorectal origin. Data were analyzed from a prospectively collected database.

Results: The median age was 59 (29-78). In three patients, PC was diagnosed during emergency surgery. The primary tumor was located in the rectum (three patients; one with recurrent disease), left colon (9 patients), and right colon (7 patients). All patients underwent CRS and IPC, and one patient operated laparoscopically. Median peritoneal cancer index (PCI) was 5 (range, 3-14), and complete cytoreduction (CC-0) was achieved in 14 patients. After CRS, 8 patients received early postoperative intraperitoneal chemotherapy (EPIC), 7 patients received hyperthermic intraperitoneal chemotherapy (HIPEC), and 4 patients received both HIPEC and EPIC. The median hospital stay was 9 (6-29) days. Postoperative complications occurred in 6 patients. There was no postoperative mortality. Median follow-up was 40.2 (12-94) months. Five-year overall survival was 63.2%. Estimated mean survival time is longer in patients who underwent complete cytoreduction compared to patients having CC-1 or CC-2 cytoreduction (87.7 vs. 20.3 months; p < 0.001).

Conclusion: Cytoreductive surgery and IPC can be performed safely in patients with intraoperatively detected incidental PC of colorectal origin.

Keywords: Colorectal; EPIC; HIPEC; Incidental; Intraoperative detected; Intraperitoneal chemotherapy; Peritoneal carcinomatosis.

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Conflict of interest statement

Ethics approval and consent to participate

This study is approved by the Dokuz Eylul University Non-interventional Studies Ethics Committee (2012/34-03).

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram of the study
Fig. 2
Fig. 2
Kaplan–Meier survival curve for median survival
Fig. 3
Fig. 3
Kaplan–Meier survival curves following complete and incomplete cytoreduction
See this image and copyright information in PMC

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