Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis. Issue 10 (11th March 2020)

• Record Type: Journal Article
• Authors: Chin, Ken Min; Tan, Grace Hwei Ching; Chia, Claramae Shulyn; Ong, Johnny Chin Ann; Teo, Melissa Ching Ching
• Is Part Of: ANZ journal of surgery. Volume 90:Issue 10(2020)
• Page Start: 1958
• Page End: 1964
• Publication Date: 2020-03-11
• Subjects: colorectal cancer -- cytoreductive surgery -- hyperthermic intraperitoneal chemotherapy -- peritoneal carcinomatosis -- recurrent; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.15783
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: This study aimed to determine pre‐ and peri‐operative parameters with significant predictive value for post‐operative outcomes in patients with recurrent colorectal cancer presenting as peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS‐HIPEC), and to develop a novel prognostic scoring system for prediction of survival outcomes. Methods: A single‐institution review of prospectively collected data from all patients who underwent CRS‐HIPEC between October 2005 and October 2017 was conducted. Univariate and multivariate analyses were used to identify significant parameters for prediction of post‐CRS‐HIPEC disease‐free survival and overall survival (OS). Results: A total of 278 patients underwent CRS‐HIPEC, of whom 72 were for peritoneal carcinomatosis from recurrent colorectal cancer. Disease‐free interval (DFI; P = 0.006), peritoneal cancer index (PCI; P = 0.001) and left upper quadrant disease ( P = 0.023) were significant independent predictors of 3‐year OS. DFI (0.007), PCI ( P < 0.001) and intraoperative blood loss (BL; P = 0.001) were significant independent predictors of 5‐year OS. PCI and BL were significant independent predictors of both 3‐year ( P = 0.026, PCI; P = 0.009, BL) and 5‐year ( P = 0.002, PCI; P = 0.011, BL) disease‐free survival. Predictive models were developed for risk stratification of OS. Conclusion: PCI, DFI, left upper quadrant disease and BL have significant predictive value for post‐CRS‐HIPEC outcomes. Risk stratification models allow for more prudent patient selection and ultimately more accurate prognostication of post‐operative outcomes. Abstract : We determined pre‐ and peri‐operative parameters with significant predictive value for post‐operative outcomes in patients with recurrent colorectal cancer presenting as peritoneal carcinomatosis undergoing Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Our prognostic models provide an objective and simple risk stratification system for accurately prognosticating patients following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.