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Annals of Surgical Oncology 10:508-513 (2003)
© 2003 Society of Surgical Oncology

NEW APPROACHES TO THE TREATMENT OF HEPATIC MALIGNANCIES

Cytoreductive Surgery Combined With Hyperthermic Intraperitoneal Intraoperative Chemotherapy for Peritoneal Carcinomatosis Arising From Colon Adenocarcinoma

Pierluigi Pilati, MD, Simone Mocellin, MD, Carlo Riccardo Rossi, MD, Mirto Foletto, MD, Luca Campana, MD, Donato Nitti, MD and Mario Lise, MD

From the Surgery Branch, Department of Oncological and Surgical Sciences, University of Padova, Padova, Italy.

Correspondence: Address correspondence and reprint requests to: Carlo Riccardo Rossi, MD, Università di Padova, Dipartimento di Scienze Oncologiche e Chirurgiche, Sezione di Clinica Chirurgica II, Via Giustiniani, 2, 35128 Padova, Italy; Fax: 39-049-651891; E-mail: carlor.rossi{at}unipd.it

ABSTRACT

Background: Hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) has been recently proposed to treat peritoneal carcinomatosis arising from colon adenocarcinoma, which is usually regarded as a lethal clinical entity. The purpose of this study was to evaluate the clinical outcome of this combined treatment.

Methods: A retrospective study of 46 patients treated for peritoneal carcinomatosis from colon adenocarcinoma was performed. Thirty-four patients were treated with complete cytoreductive surgery immediately followed by intraoperative HIIC with mitomycin C and cisplatin. The clinical outcome of these 34 patients was analyzed; the median follow-up period was 14.5 months.

Results: No postoperative deaths were reported. The postoperative morbidity rate was 35%. No severe locoregional or systemic toxicity was observed. The 2-year overall survival was 31%, and the median survival time and the median time to local disease progression were 18 and 13 months, respectively. Survival and local disease control in patients with well- and moderately differentiated colon adenocarcinoma were significantly better than in those with poorly differentiated tumors.

Conclusions: Considering the dismal prognosis of this condition, HIIC seems to achieve encouraging results in a selected group of patients affected with resectable peritoneal carcinomatosis arising from colon adenocarcinoma. These findings support the conduction of formal phase III randomized trials.

Key Words: Peritoneal carcinomatosis • Colon adenocarcinoma • Cytoreductive surgery • Hyperthermic intraperitoneal intraoperative chemotherapy




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