Management for Peritoneal Metastasis of Colonic Origin: Role of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy: A Single Institution's Experience During Two Decades.

MedStar author(s):
Citation: Annals of Surgical Oncology. 24(4):898-905, 2017 AprPMID: 27878480Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: Surgery/General SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Antineoplastic Combined Chemotherapy Protocols/ad [Administration & Dosage] | *Colonic Neoplasms/pa [Pathology] | *Cytoreduction Surgical Procedures | *Peritoneal Neoplasms/sc [Secondary] | *Peritoneal Neoplasms/th [Therapy] | Adolescent | Adult | Aged | Aged, 80 and over | Biomarkers, Tumor/bl [Blood] | CA-125 Antigen/bl [Blood] | Capecitabine/ad [Administration & Dosage] | Chemotherapy, Adjuvant | Female | Fluorouracil/ad [Administration & Dosage] | Follow-Up Studies | Humans | Infusions, Parenteral | Male | Middle Aged | Mitomycin/ad [Administration & Dosage] | Mucin-1/bl [Blood] | Neoadjuvant Therapy | Neoplasm, Residual | Organoplatinum Compounds/ad [Administration & Dosage] | Retrospective Studies | Survival Rate | Young AdultYear: 2017Local holdings: Available online from MWHC library: 1994 - presentISSN:
  • 1068-9265
Name of journal: Annals of surgical oncologyAbstract: BACKGROUND: Peritoneal metastasis of colonic origin is associated with a poor prognosis. This study aimed to analyze the clinicopathologic characteristics and prognostic predictors of survival in a cohort of patients treated with cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (POIC) during two decades.CONCLUSION: For patients with a limited extent of peritoneal metastases, CC is the most important prognostic variable for improved survival of colon cancer patients with peritoneal metastases.METHODS: A retrospective study analyzed a prospectively maintained database for all patients treated for peritoneal metastasis of a colonic origin (PCC) from January 1990 to April 2015.RESULTS: The 318 patients in our study comprised 171 men (53.8%) and 147 women (46.2%). The mean age of the patients at presentation was 50.6 years, (range 18-86 years). Overall survival was 42.5%, median survival and follow-up time was 21.5 and 15.0 months respectively. The 3 and 5 years survival rates were respectively 35 and 25%. The median survival time was 20.6 months for the men and 23.1 months for the women (p = 0.14). The mean intraoperative peritoneal carcinomatosis index (PCI) was 15.2. The patients who had a completeness of cytoreduction (CC) score of 0 or 1 (no residual disease <0.25 mm) had a median survival time of 36.6 months compared with 18.3 months for the patients with a CC-2 score and 7.6 months for the patients with a CC-3 score (p < 0.000). The significant independent predictors of survival in the multivariate analysis were the CC score and elevated tumor makers CA153 and CA125.All authors: Ihemelandu C, Sugarbaker PHFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27878480 Available 27878480

Available online from MWHC library: 1994 - present

BACKGROUND: Peritoneal metastasis of colonic origin is associated with a poor prognosis. This study aimed to analyze the clinicopathologic characteristics and prognostic predictors of survival in a cohort of patients treated with cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (POIC) during two decades.

CONCLUSION: For patients with a limited extent of peritoneal metastases, CC is the most important prognostic variable for improved survival of colon cancer patients with peritoneal metastases.

METHODS: A retrospective study analyzed a prospectively maintained database for all patients treated for peritoneal metastasis of a colonic origin (PCC) from January 1990 to April 2015.

RESULTS: The 318 patients in our study comprised 171 men (53.8%) and 147 women (46.2%). The mean age of the patients at presentation was 50.6 years, (range 18-86 years). Overall survival was 42.5%, median survival and follow-up time was 21.5 and 15.0 months respectively. The 3 and 5 years survival rates were respectively 35 and 25%. The median survival time was 20.6 months for the men and 23.1 months for the women (p = 0.14). The mean intraoperative peritoneal carcinomatosis index (PCI) was 15.2. The patients who had a completeness of cytoreduction (CC) score of 0 or 1 (no residual disease <0.25 mm) had a median survival time of 36.6 months compared with 18.3 months for the patients with a CC-2 score and 7.6 months for the patients with a CC-3 score (p < 0.000). The significant independent predictors of survival in the multivariate analysis were the CC score and elevated tumor makers CA153 and CA125.

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