Perioperative and Oncological Outcomes of Combined Hepatectomy with Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Metastatic Colorectal Cancer.

Tytuł:: Perioperative and Oncological Outcomes of Combined Hepatectomy with Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Metastatic Colorectal Cancer.
Autorzy:: Adileh M; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Mor E; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Assaf D; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Benvenisti H; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Laks S; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Ben-Yaacov A; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Schtrechman G; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Hazzan D; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Shacham-Shmueli E; The Department of Oncology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Margalit O; The Department of Oncology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Halpern N; The Department of Oncology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Aderka D; The Department of Oncology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Perelson D; The Department of Anesthesiology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Ariche A; The Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Nissan A; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel. .
Źródło:: Annals of surgical oncology [Ann Surg Oncol] 2021 Jun; Vol. 28 (6), pp. 3320-3329. Date of Electronic Publication: 2020 Sep 23.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2005- : New York, NY : Springer
Original Publication: New York, NY : Raven Press, c1994-
MeSH Terms:: Colorectal Neoplasms*/surgery
Hyperthermia, Induced*
Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Hepatectomy ; Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Prospective Studies ; Retrospective Studies ; Survival Rate
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Entry Date(s):: Date Created: 20200924 Date Completed: 20210517 Latest Revision: 20220128
Update Code:: 20240105
DOI:: 10.1245/s10434-020-09165-3
PMID:: 32968959
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Background: Synchronous peritoneal and liver metastasis in colorectal cancer is a relative contraindication for curative surgery. We aimed to evaluate the safety and oncological outcomes of combined treatment of peritoneal and liver metastasis.
Methods: We conducted a retrospective analysis of metastatic colorectal cancer patients from two prospective databases: peritoneal surface malignancy (n = 536) and hepatobiliary (n = 286). We compared 60 patients treated with cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) and hepatectomy; 80 patients treated with cytoreduction and HIPEC only; and 63 patients treated with hepatectomy alone.
Results: No differences in demographics were observed between the groups. Median hospital and intensive care unit (ICU) stay was shorter in group C (7 and 1 days, respectively) versus groups A and B (13 and 1 days, and 12 and 1 days, respectively; p < 0.001). Postoperative complications were not significantly different. Median follow-up was 18.6, 23.1, and 30.6 months for groups A, B, and C, respectively. Estimated 5-year overall survival (OS) was 48.8% (group A), 55.4% (group B), and 60.2% (group C) [p = 0.043 for group A vs. group C], and estimated 5-year disease-free survival (DFS) was 14.2% (group A), 23.0% (group B), and 18.6% (group C). Five-year OS was superior in group C compared with group A (p = 0.043), and DFS was superior in group C compared with groups A and B (p = 0.043 and 0.03, respectively). The peritoneum was the site of first recurrence in groups A and B (23.3% and 32.5%, respectively), and the liver was the site of first recurrence in group C (44.4%).
Conclusions: We report favorable perioperative and oncological outcomes in combined cytoreduction/HIPEC and hepatectomy for patients with peritoneal and liver metastasis. Surgical intervention after multidisciplinary discussion should be considered in patients with both peritoneal and hepatic lesions when complete cytoreduction is feasible.

Comment in: Ann Surg Oncol. 2021 Dec;28(Suppl 3):808-809. (PMID: 33638040)
Comment in: Ann Surg Oncol. 2021 Dec;28(Suppl 3):806-807. (PMID: 33638042)

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