Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2005

01-01-2005 | Original Article

Long-Term Survival of Peritoneal Carcinomatosis of Colorectal Origin

Authors: Vic J. Verwaal, MD, PhD, Serge van Ruth, MD, PhD, Arjen Witkamp, MD, PhD, Henk Boot, MD, PhD, Gooike van Slooten, MD, Frans A. N. Zoetmulder, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2005

Login to get access

Abstract

Background

Peritoneal carcinomatosis of colorectal cancer is probably best treated by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). In The Netherlands Cancer Institute, this treatment has been performed since 1995. The long tradition of this treatment enabled us to study long-term survival in detail.

Methods

Between 1995 and 2003, 117 patients were treated by cytoreduction and HIPEC. The aim of the cytoreduction was to remove all visible tumor. After the cytoreduction, the abdomen was perfused with mitomycin C (35 mg/m2) at 40°C to 41°C for 90 minutes. Survival was calculated by the Kaplan-Meier method. Survival was also analyzed for the following subgroups: no residual tumor, residual tumor ≤2.5 mm, and more residual tumor. Hazard ratios for each of the seven abdominal regions were calculated to determine the influence on survival.

Results

The median survival was 21.8 months. The 1-, 3-, and 5-year survival rates were 75%, 28%, and 19%, respectively. The Kaplan-Meier curve reached a plateau of 18% at 54 months. In 59 patients a complete cytoreduction was achieved, and in 41 patients there was minimal residual disease. The median survival of these patient groups was 42.9 and 17.4 months, respectively. When gross macroscopic tumor was left behind, as was the case in 17 patients, the median survival was 5 months. Involvement of the small bowel before cytoreduction was associated with poorer outcome.

Conclusions

Cytoreduction followed by HIPEC showed a median survival of 21 months. From 3 years on, a consistent group of 18% of patients stayed alive.
Literature
1.
Sugarbaker, PH 1993Peritoneal carcinomatosisWanebo, HJ eds. Colorectal CancerMosbySt. Louis42836
2.
Carraro, PG, Segala, M, Cesana, BM, Tiberio, G 2001Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage curative surgeryDis Colon Rectum4424350PubMed
3.
Jayne, DG, Fook, S, Loi, C, Seow-Choen, F 2002Peritoneal carcinomatosis from colorectal cancerBr J Surg89154550PubMed
4.
Russell, AH, Pelton, J, Reheis, CE, Wisbeck, WM, Tong, DY, Dawson, LE 1985Adenocarcinoma of the colon: an autopsy study with implications for new therapeutic strategiesCancer56144651PubMed
5.
Sadeghi, B, Arvieux, C, Glehen, O,  et al. 2000Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective studyCancer8835863PubMed
6.
Shen, P, Levine, EA, Hall, J,  et al. 2003Factors predicting survival after intraperitoneal hyperthermic chemotherapy with mitomycin C after cytoreductive surgery for patients with peritoneal carcinomatosisArch Surg1382633CrossRefPubMed
7.
8.
Sugarbaker, PH 2003Carcinomatosis—is cure an option?J Clin Oncol217624PubMed
9.
Elias, D, Blot, F, El Otmany, A,  et al. 2001Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapyCancer92716CrossRefPubMed
10.
Loggie, BW, Fleming, RA, McQuellon, RP, Russell, GB, Geisinger, KR 2000Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for disseminated peritoneal cancer of gastrointestinal originAm Surg665618PubMed
11.
Piso, P, Bektas, H, Werner, U,  et al. 2001Improved prognosis following peritonectomy procedures and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from appendiceal carcinomaEur J Surg Oncol2728690CrossRefPubMed
12.
Verwaal, VJ, Van Ruth, S, de Bree, E,  et al. 2003Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancerJ Clin Oncol21373743CrossRefPubMed
13.
Verwaal, VJ, Tinteren, H, Ruth, S, Zoetmulder, FAN 2004Toxicity of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapyJ Surg Oncol85617PubMed
14.
Essquivel, J, Vidal-Jove, J, Steves, MA, Sugarbaker, PH 1993Morbidity and mortality of cytoreductive surgery and intraperitoneal chemotherapySurgery1136316
15.
Loggie, BW, Fleming, RA 1996Complications of heated intraperitoneal chemotherapy and strategies for preventionSugarbaker, PH eds. Peritoneal Carcinomatosis: Principles of ManagementKluwer AcademicBoston22133
16.
17.
Witkamp, AJ, de Bree, E, Van Goethem, R, Zoetmulder, FA 2001Rationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapyCancer Treat Rev2736574PubMed
18.
Laufman, LR, Krzeczowski, KA, Roach, R, Segal, M 1987Leucovorin plus 5-fluorouracil: an effective treatment for metastatic colon cancerJ Clin Oncol51394400PubMed
19.
Iveson, TJ, Hickish, T, Schmitt, C, Cutsem, E 1999Irinotecan in second-line treatment of metastatic colorectal cancer: improved survival and cost-effect compared with infusional 5-FUEur J Cancer351796804PubMed
20.
Shimada, Y, Rougier, P, Pitot, H 1996Efficacy of CPT-11 (irinotecan) as a single agent in metastatic colorectal cancerEur J Cancer32AS137PubMed
21.
Sugarbaker, PH, Chang, D 1999Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancyAnn Surg Oncol672731PubMed
22.
Beaujard, AC, Glehen, O, Caillot, JL,  et al. 2000Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosisCancer8825129PubMed
23.
Cavaliere, F, Perri, P, Di Filippo, F,  et al. 2000Treatment of peritoneal carcinomatosis with intent to cureJ Surg Oncol74414PubMed
24.
Verwaal, VJ, Tinteren, H, Ruth, S, Zoetmulder, FAN 2004Predicting survival of peritoneal carcinomatosis of colorectal origin treated by aggressive cytoreduction and hyperthermic intra-peritoneal chemotherapyBr J Surg9173946PubMed
25.
McQuellon, RP, Loggie, BW, Fleming, RA, Russell, GB, Lehman, AB, Rambo, TD 2001Quality of life after intraperitoneal hyperthermic chemotherapy (IPHC) for peritoneal carcinomatosisEur J Surg Oncol276573CrossRefPubMed
26.
McQuellon, RP, Loggie, BW, Lehman, AB,  et al. 2003Long-term survivorship and quality of life after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosisAnn Surg Oncol1015562CrossRefPubMed
Metadata
Title
Long-Term Survival of Peritoneal Carcinomatosis of Colorectal Origin
Authors
Vic J. Verwaal, MD, PhD
Serge van Ruth, MD, PhD
Arjen Witkamp, MD, PhD
Henk Boot, MD, PhD
Gooike van Slooten, MD
Frans A. N. Zoetmulder, MD, PhD
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1007/s10434-004-1167-z

Other articles of this Issue 1/2005

Annals of Surgical Oncology 1/2005 Go to the issue

Original Article

Lymph Node Metastasis in Epithelial Malignancies of the Appendix With Peritoneal Dissemination Does Not Reduce Survival in Patients Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

Original Article

Axillary Recurrence After a Negative Sentinel NodeBiopsy for Breast Cancer: Incidence and Clinical Significance

Original Article

The Indications for and the Prognostic Significance of Amputation as the Primary Surgical Procedure for Localized Soft Tissue Sarcoma of the Extremity

Original Article

Ultrasound Examination of Sentinel Nodes in the Initial Assessment of Patients With Primary Cutaneous Melanoma

Original Article

Axillary Recurrence After Sentinel Node Biopsy

Original Article

Beyond the Clinical Trials: How Often Is Sentinel Lymph Node Dissection Performed for Breast Cancer?