In a nutshell
This study compared the effectiveness of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) with other treatment options in patients with colorectal cancer (CRC) and peritoneal metastasis (PM; when cancer spreads to the abdominal lining). Researchers suggested that CRS + HIPEC brings the greatest benefit to these patients.
Some background
PM affects around 10% of patients with CRC and is associated with poor outcomes. This is true even when these patients are treated with modern chemotherapy. Survival improvements have been reported with CRS and HIPEC. CRS involves the surgical removal of tumors from the abdominal lining. HIPEC is a heated, highly concentrated chemotherapy that is delivered directly to the abdomen during CRS. The effectiveness of CRS combined with HIPEC compared to other treatment options to treat PM in patients with CRC is not clear.
Methods & findings
This study included information about 370 patients with CRC and PM. Patients were divided into 5 different groups. Group A received CRS and HIPEC (7.6% of patients), group B received surgery and chemotherapy (22.1%), group C received chemotherapy only (36.2%), group D received surgery only (12.2%) and group E received best supportive care (treatment of symptoms only (21.9%).
The average overall survival (OS; total time patients were alive after treatment) was the highest for patients in group A (41.6 months). Patients from group B had an OS of 24 months. Group C had an OS of 14.1 months, group D of 11.4 months and group E of 7.9 months.
Compared to group E, patients in group A had an 81% higher chance of survival. Group B had a 60% higher survival and groups C and D had a 43 and a 42 higher survival than group E.
The bottom line
This study reported that patients with colorectal cancer and peritoneal metastasis would significantly benefit from cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy.
The fine print
This was a retrospective study. It means the authors looked back in time to analyze data.
Published By :
International Journal of Colorectal Disease
Date :
Aug 21, 2018
