Oncotarget

Research Papers:

Colorectal cancer at high risk of peritoneal metastases: long term outcomes of a pilot study on adjuvant laparoscopic HIPEC and future perspectives

Charlotte E.L. Klaver _, Roos Stam, Didi A.M. Sloothaak, Johannes Crezee, Willem A. Bemelman, Cornelis J.A. Punt and Pieter J. Tanis

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Oncotarget. 2017; 8:51200-51209. https://doi.org/10.18632/oncotarget.17158

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Abstract

Charlotte E.L. Klaver1, Roos Stam1, Didi A.M. Sloothaak1, Johannes Crezee2, Willem A. Bemelman1, Cornelis J.A. Punt3 and Pieter J. Tanis1

1Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

2Department of Radiation Oncology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

3Department of Medical Oncology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Correspondence to:

Pieter J. Tanis, email: p.j.tanis@amc.uva.nl

Keywords: colorectal cancer, peritoneal metastases, adjuvant HIPEC

Received: September 26, 2016     Accepted: March 10, 2017     Published: April 17, 2017

ABSTRACT

Objective: Early detection of peritoneal metastases (PM) of colorectal cancer (CRC) is difficult and treatment options at a clinically overt stage are limited. Potentially, adjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) is of value. The aim of this study was to present long term oncological outcomes of a pilot study on adjuvant HIPEC to reduce development of PMCRC, with systematic review of literature.

Methods: Long term oncological outcomes of ten patients who underwent laparoscopic HIPEC within eight weeks after resection of primary CRC in the pilot study were retrospectively collected. A systematic search of literature was performed on studies describing the use of HIPEC in patients with CRC at high risk of developing PM.

Results: The median follow-up was 54 months (range 49-63). All patients were alive at the last follow-up moment and none of them had developed PM. Two patients had developed pulmonary metastases. Systematic review revealed five small cohort studies, including two matched comparisons. Peritoneal recurrences were found in 0% to 9% after adjuvant HIPEC, which was 28% and 43% in the two control groups, respectively. Disease free and overall survival were significantly higher in favour of HIPEC.

Conclusion: Long term follow-up of ten patients included in a pilot study on adjuvant HIPEC revealed no peritoneal recurrences. This result is in line with other published pilot studies, a promising observation. However, the outcomes of the Dutch randomized COLOPEC trial and similar trials worldwide should be awaited for definitive conclusions on the effectiveness of adjuvant HIPEC.


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