594P - Peritoneal carcinomatosis (PC) from colo-rectal origin. Results of 200 patients treated by radical surgery (CRS) plus hyperthermic intraperitoneal...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Pedro Barrios
Citation Annals of Oncology (2014) 25 (suppl_4): iv167-iv209. 10.1093/annonc/mdu333
Authors P. Barrios1, O. Crusellas1, J. Castellvi1, F. Losa2, G. Soler3, V. Fuste4, M. Martin5, G. Galofre1, I. Ramos6
  • 1Surgery, CSI, 08970 - Sant Joan Despi/ES
  • 2Medical Oncology, Hospital General de L´Hospitalet, 08906 - Barcelona/ES
  • 3Medical Oncology, ICO, Hospitalet/ES
  • 4Pathology, CSI, 08970 - Sant Joan Despi/ES
  • 5Epidemiology, CSI, 08970 - Sant Joan Despi/ES
  • 6Surgery, CSI, 08970 - Sant Joan Despí/ES

Abstract

Aim

Up to 25% of colorectal cancer patients will present PC during follow up. Numerous recent studies in selected group of patients with colorectal PC, treated with CRS + HIPEC and postoperative chemotherapy, report a 5-year survivals of 30-52%. The aggressiveness and surgical risk related to this treatment modality should outweigh the benefits achieved by other therapies. We present our survival results, as well as relevant prognostic indicators in overall survival.

Methods

From September 2006 to April 2014, 466 patients with PC from different types of Peritoneal Surface Malignancies have been treated by 513 CRS + HIPEC procedures. Of those, 200 had carcinomatosis from colon tumors, treated by 216 CRS + HIPEC procedures.CRS was achieved using up to six peritonectomy procedures, and HIPEC following coliseum (open) technique employing oxaliplatin (86%) or irinotecan (14%), at 42.5°C during 30 minutes. Bidirectional chemotherapy, one hour before HIPEC. The overall survival has been correlated to tumor histology, volume of peritoneal disease (PCI), radicalness of resection and presence of other forms of metastasic disease.

Results

A third party is currently auditing these preliminary results, to be done before August 2014. 117 females and 83 males. Mean age of 55.3 years. Prior chemotherapy and prior surgery: 95.5% and 93.5% respectively. Mean PCI: 8.7/39. CRS (CC0 and CC1): 98.1%. Mean operative time: 339 minutes (210-845). ICU and Hospital stay: 2 and 12 days. Median follow up: 20.9 months (1.0-80.8). Overall morbidity: 18.8%. Reoperations: 3.3%. No anastomotic complications. In-house and 30 day mortality rate: 0%. Probability of survival (sv) at 12 months: 91.5%, at 3 years 48.3%, at 5 years 32%. Mean overall sv of 41.3 months; For PCI 0-10, sv 50.3 m, PCI 11-20, sv 31.8 m, PCI 21-30, sv 21.7 m, For CC0, 42.3 m, CC1, 32.4 m, CC2, 11 m For classic adenocarcinoma, 37.4 m, mucinous adenoca, 27.4 m, presence of signet ring cells, 17.2 m, absence, 40.6 m. For Histologic Grade 1-2, 38.3 m, Grade 3, 26.6 m. For presence of hepatic metastasis, 40.6 m, absence, 40.0 m.

Conclusions

CRS + HIPEC with systemic adjuvant chemotherapy is considered standard treatment for PC from colo-rectal origin. Prognostic indicators of improved survival include low to moderate PCI (<21/39), complete radical surgery, absence of signet ring cell histology and early therapy implementation.

Disclosure

All authors have declared no conflicts of interest.