Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: October 22, 2021
Accepted: January 28, 2022
Published online: February 23, 2022

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 2

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

Abstract

Background: The surgical management of peritoneal metastases from colorectal cancer has been a topic of controversial discussion for many decades. Peritonectomy and perioperative intraperitoneal chemotherapy added options for surgical treatment of this condition beyond palliative surgery. The most favorable outcomes are recorded when peritoneal metastases from colorectal cancer can be resected to no visible evidence of disease. Methods: To determine if any benefit from surgical treatment of patients with colorectal peritoneal metastases can occur from incomplete resection of peritoneal metastases, we studied patients by the completeness of cytoreduction (CC) score. The CC-3 indicated a palliative resection, CC-2 gross residual disease, and CC-1 almost complete cytoreduction but visible residual disease. The impact of clinical-, pathologic-, and treatment-related variables on the survival of the three groups was compared. Results: Eighty-five patients with long-term follow-up were available for study. The median age was 53 years (range 18–82). There were 60 males (70.6%). Symptomatic patients, those with bowel obstruction, and patients with positive retroperitoneal lymph nodes had significantly reduced survival. The median survival of the CC-3, CC-2, and CC-1 groups were significantly different (p = 0.0027). The 2-year or greater survivals of the three groups were 4.8%, 15.1%, and 38.7%, respectively. Conclusions: If a near complete cytoreduction combined with hyperthermic intraperitoneal chemotherapy can be performed, short-term survival benefit could be observed.

© 2022 S. Karger AG, Basel

References Sugarbaker PH. Colorectal cancer metastases: a surgical perspective. Surg Oncol Clin N Am. 2013;22(2):289–98. Sugarbaker PH. Colorectal cancer: management of metastatic disease. Eur Oncol Haematol. 2013;9(2):100–4. Hughes KS, Scheele J, Sugarbaker PH. Surgery for colorectal cancer metastatic to the liver: optimizing the results of treatment. Surg Clin North Am. 1989;69(2):339–59. Kemeny NE, Gonen M. Hepatic arterial infusion after liver resection. N Engl J Med. 2005;352(7):734–5. Hughes KS, Simons R, Songhorabodi S, Adson MA, Ilstrup DM, Fortner JG, et al. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Surgery. 1998 Aug;100(2):278–88. Jacquet P, Sugarbaker PH. Current methodologies for clinical assessment of patients with peritoneal carcinomatosis. J Exp Clin Cancer Res. 1996;15(1):49–58. Sugarbaker PH, Low RN, editors. Pictorial essays on peritoneal metastases imaging: CT, MRI and PET-CT. Hauppauge, NY: Nova Science Publishers; 2020. Elias D, Gilly F, Boutitie F, Quenet F, Bereder JM, Mansvelt B, et al. Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy: retrospective analysis of 523 patients from a multicentric French study. J Clin Oncol. 2009;28:63–8. Lambert LA, Hendrix RJ. Palliative management of advanced peritoneal carcinomatosis. Surg Oncol Clin N Am. 2018;27:585–602. Bijelic L, Sugarbaker PH. Cytoreduction of the small bowel surfaces. J Surg Oncol. 2008;97(2):176–9. Van der Speeten K, Stuart OA, Sugarbaker PH. Cancer chemotherapy for peritoneal metastases: pharmacology and treatment. In: Sugarbaker PH, editor. Cytoreductive surgery & perioperative chemotherapy for peritoneal surface malignancy. Textbook and Video Atlas. 2nd ed. Woodbury, CT: Cine-Med Publishing; 2017. p. 47–82. Van der Speeten K, Stuart OA, Chang D, Mahteme H, Sugarbaker PH. Changes induced by surgical and clinical factors in the pharmacology of intraperitoneal mitomycin C in 145 patients with peritoneal carcinomatosis. Cancer Chemother Pharmacol. 2011;68:147–56. Van der Speeten K, Stuart OA, Mahteme H, Sugarbaker PH. A pharmacologic analysis of intraoperative intracavitary cancer chemotherapy with doxorubicin. Cancer Chemother Pharmacol. 2009;63(5):799–805. Ozols RF, Locker GY, Doroshow JH, Grotzinger KR, Myers CE, Young RC. Pharmacokinetics of adriamycin and tissue penetration in murine ovarian cancer. Cancer Res. 1979;39(8):3209–14. Jacquet P, Averbach A, Stuart OA, Chang D, Sugarbaker PH. Hyperthermic intraperitoneal doxorubicin: pharmacokinetics, metabolism, and tissue distribution in a rat model. Cancer Chemother Pharmacol. 1998;41(2):147–54. Goldie JH, Coldman AJ. Application of theoretical models to chemotherapy protocol design. Cancer Treat Rep. 1986;70(1):127–31. Sugarbaker PH, Averbach AM, Jacquet P, Stephens AD, Stuart OA. A simplified approach to hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) using a self retaining retractor. In: Sugarbaker PH, editor. Peritoneal carcinomatosis: principles of management. Boston: Kluwer; 1996. p. 415–21. Passot G, Vaudoyer D, Cotte E, You B, Isaac S, Noël Gilly F, et al. Progression following neoadjuvant systemic chemotherapy may not be a contraindication to a curative approach for colorectal carcinomatosis. Ann Surg. 2012;256(1):125–9. Sethna KS, Sugarbaker PH. New prospects for the control of peritoneal surface dissemination of gastric cancer using perioperative intraperitoneal chemotherapy. Cancer Therapy. 2004;2:79–84. Sugarbaker PH, Alderman R, Edwards G, Marquardt CE, Gushchin V, Esquivel J, et al. Prospective morbidity and mortality assessment of cytoreductive surgery plus perioperative intraperitoneal chemotherapy to treat peritoneal dissemination of appendiceal mucinous malignancy. Ann Surg Oncol. 2006;13(5):635–44. Yan TD, Edwards G, Alderman R, Marquardt CE, Sugarbaker PH. Morbidity and mortality assessment of cytoreductive surgery and perioperative intraperitoneal chemotherapy for diffuse malignant peritoneal mesothelioma: a prospective study of 70 consecutive cases. Ann Surg Oncol. 2007;14(2):515–25. Sugarbaker PH. Epithelial appendiceal neoplasms. Cancer J. 2009 May–Jun;15(3):225–35. Van der Speeten K, Stuart OA, Mahteme H, Sugarbaker PH. A pharmacologic analysis of intraoperative intracavitary cancer chemotherapy with doxorubicin. Cancer Chemother Pharmacol. 2009;63(5):799–805. Sugarbaker PH. New standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome? Lancet Oncol. 2006;7(1):69–76. Sugarbaker PH, Deng T, Chang D. Peritoneal cytology as an indicator of peritoneal metastases in colorectal cancer. J Surg Oncol. 2021 Sep;124(3):361–6. Goere D, Souadka A, Faron M, Cloutier AS, Viana B, Honoré C, et al. Extent of colorectal peritoneal carcinomatosis: attempt to define a threshold above which HIPEC does not offer survival benefit: a comparative study. Ann Surg Oncol. 2015;22:2958–64. Jayakrishnan TT, Zacharias AJ, Sharma A, Pappas SG, Gamblin TC, Turaga KK. Role of laparoscopy in patients with peritoneal metastases considered for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). World J Surg Oncol. 2014;12:270. Guaglio M, Baratti D, Kusamura S, Reis ACV, Montenovo M, Bartolini V, et al. Impact of previous gynecologic surgical procedures on outcomes of non-gynecologic peritoneal malignancies mimicking ovarian cancer: less is more? Ann Surg Oncol. 2021;28:2899–908. Sugarbaker PH. Update on selection of patients for treatment of lymph node positive colorectal peritoneal metastases. J Surg Oncol. 2022. Baratti D, Kusamura S, Niger M, Perrone F, Milione M, Cattaneo L, et al. Prognostic impact of primary side and RAS/RAF mutations in a surgical series of colorectal cancer patients with peritoneal metastases. Ann Surg Oncol. 2021;28:3332–42. Long KL, Ingraham AM, Wendt EM, Saucke MC, Balentine C, Orne J, et al. Informed consent and informed decision-making in high-risk surgery: a quantitative analysis. J Am Coll Surg. 2021;233(3):337–45. Article / Publication Details

First-Page Preview

Received: October 22, 2021
Accepted: January 28, 2022
Published online: February 23, 2022

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 2

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.