Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases in an elderly population: outcomes from a single centre. Issue 9 (9th May 2022)

• Record Type: Journal Article
• Authors: Flood, Michael P.; Narasimhan, Vignesh; Waters, Peadar S.; Kong, Joseph C.; Ramsay, Robert; Michael, Michael; Tie, Jeanne; McCormick, Jacob J.; Warrier, Satish K.; Heriot, Alexander G.
• Is Part Of: ANZ journal of surgery. Volume 92:Issue 9(2022)
• Page Start: 2192
• Page End: 2198
• Publication Date: 2022-05-09
• Subjects: colorectal peritoneal metastases -- cytoreductive surgery -- elderly -- hyperthermic intraperitoneal chemotherapy -- morbidity; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.17761
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The prevalence of elderly patients with resectable colorectal peritoneal metastases (CRPM) is increasing. This study aimed to compare short and long‐term outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for CRPM in patients above and below 70 years of age. Methods: This was a retrospective, 10‐year analysis of 90‐day major morbidity and mortality, and long‐term survival. Results: Thirty‐two (21.3%) of 150 consecutive patients who underwent CRS and HIPEC during the study period were aged 70 and older. PCI ( P = 0.04), perioperative chemotherapy use ( P < 0.01) and organ resections (rectum P = 0.04, diaphragm P = 0.03) were less in the over 70 group. There was no significant differences in major morbidity ( P = 0.19) and mortality ( P = 0.32). There was also no difference in 5‐year overall survival (OS) (≥70: 26% vs. <70: 39%; P = 0.68) and disease‐free survival (DFS) (≥70: 25% vs. <70: 14%; P = 0.22). Age above 70 was not independently associated with worse OS (HR 1.55, P = 0.20) and DFS (HR 1.07, P = 0.81). Conclusion: The surgical management of CRPM appears safe and feasible in this elderly population. Appropriate selection of elderly patients for such radical intervention is reinforced by the comparable survival with those under 70. Abstract : The absolute numbers of elderly patients with colorectal peritoneal metastases is expected to increase. We retrospectively analysed CRS and HIPEC data from a single institution over a 10‐year period, and compared outcomes between patients under and over 70 years of age. We concluded that in appropriately selected patients, CRS and HIPEC is safe, feasible and results in justifiable oncological outcomes for patients over the age of 70.