Complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastasis in Norway: Prognostic factors and oncologic outcome in a national patient cohort.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can offer long-term survival to patients with resectable peritoneal metastasis (PM) from colorectal cancer (CRC), a condition with otherwise dismal prognosis. This study describes short- and long-term outcome in a national patient cohort and aims to identify prognostic factors.
All patients treated with CRS-HIPEC for non-appendiceal PM-CRC in Norway 2004-2013 were included (n?=?119), and outcome and potential prognostic factors were examined using survival- and ROC-curve analysis.
Five-year overall survival (OS) and disease-free survival (DFS) were 36% and 14%, respectively, with 45 months median follow-up. The only factor associated with OS in multivariable analysis was peritoneal cancer index (PCI), with HR 1.05 (1.01-1.09) for every increase in PCI-score (P?=?0.015). Peritoneal relapse was associated with shorter OS than distant metastasis (P?=?0.002). ROC-curves identified PCI?>?12 as a marker with 100% specificity for prediction of disease relapse. Severe postoperative complications (Clavien-Dindo?=?3) occurred in 15% of patients and there was no 100-day mortality.
Long-term outcome was in line with published results, morbidity was acceptable and there was no 100-day mortality. The results reemphasize CRS-HIPEC as an important treatment option in PM-CRC, with particularly good results in patients with PCI?