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International Journal of Colorectal Disease

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01-09-2014 | Original Article

Long-term results after proactive management for locoregional control in patients with colonic cancer at high risk of peritoneal metastases

Authors: P. Sammartino, S. Sibio, D. Biacchi, M. Cardi, P. Mingazzini, M. S. Rosati, T. Cornali, B. Sollazzo, J. Maherfouad Atta, A. Di Giorgio

Published in: International Journal of Colorectal Disease | Issue 9/2014

Abstract

Purpose

A major problem in treating patients with peritoneal spread from colorectal cancer is that at diagnosis wide peritoneal involvement often precludes all curative attempts. A possible solution is to identify those patients at risk for peritoneal metastases and intervene early to prevent locoregional disease spread before it develops and, thus, to improve outcome.

Methods

We analyzed long-term results from a previous study and compared outcomes in 25 patients with advanced colon cancer considered at high risk for peritoneal spread (pT3/pT4 and mucinous or signet ring cell histology) prospectively included and managed with a proactive surgical approach including target organ resection for peritoneal spread plus hyperthermic intraperitoneal chemotherapy (HIPEC) and in 50 retrospectively well-matched controls who underwent standard surgical resection during the same period and in the same hospital by different surgical teams.

Results

At 48 months after the study closed, peritoneal metastases and local recurrence developed significantly less often in proactively managed patients than in controls (4 vs 28 %) (p < 0.03). Patients in the proactive group also survived longer than control patients (median overall survival 59.5 vs 52 months). Despite similar morbidity, Kaplan–Meier survival curves disclosed significantly longer disease-free and overall survival in the proactive than in the control group (p < 0.05 and <0.04).

Conclusions

In patients with advanced colon cancer at risk for peritoneal recurrence, the proactive surgical approach plus HIPEC seems to achieve good locoregional control preventing peritoneal spread thus improving outcome without increasing morbidity. These advantages merit investigation in a multicentric randomized trial.

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Title: Long-term results after proactive management for locoregional control in patients with colonic cancer at high risk of peritoneal metastases
Authors: P. Sammartino
S. Sibio
D. Biacchi
M. Cardi
P. Mingazzini
M. S. Rosati
T. Cornali
B. Sollazzo
J. Maherfouad Atta
A. Di Giorgio
Publication date: 01-09-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 9/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-014-1929-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term results after proactive management for locoregional control in patients with colonic cancer at high risk of peritoneal metastases

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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