Role of Early Bedside HIPEC as Adjuvant Treatment in Colorectal Peritoneal Metastasis
Spiliotis John1, Farmakis Dimitrios1, Metaxas Theodoros1, Spiliotis Nikolaos - Jasonas2, Saroyan Hayarpi1, Gianniri Mairi2, Vaikos Dimitrios1, Margari Harris2, Karachalios Dimitrios11European Interbalkan Medical Center, Thessaloniki, Greece, 2Athens medical Center Marousi, Athens, Greece,
Objectives: Peritoneal metastasis (PM) is a poor prognostic factor for all malignancies and remains difficult to treat with systemic chemotherapy because of poor peritoneal vascularization, resulting in limited drug delivery and penetration into tissues. Our study aims to investigate the efficacy and safety of different locoregional treatment protocols with hyperthermic intraperitoneal chemotherapy (HIPEC), Early Peritoneal Chemotherapy (EPIC), Pressurized Intraperitoneal Chemotherapy (PIPAC) in the management of advanced colorectal cancer with metachronous PM. Methods: A total of 42 patients were divided into three groups, as follows. Group A: After neoadjuvant systemic chemotherapy, 15 patients received cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) and then adjuvant systemic chemotherapy. Group B: After neoadjuvant systemic chemotherapy, 12 patients received CRS + HIPEC + early postoperative intraperitoneal chemotherapy for 5 postoperative days and then adjuvant systemic chemotherapy. Group C: After neoadjuvant chemotherapy, 15 patients received CRS + HIPEC and then an adjuvant bedside HIPEC on the 10th postoperative day combined with postoperative adjuvant chemotherapy. Results: Patients in group A had a median overall survival (OS) of 33 months; however, log-rank tests showed that survival distributions of the three groups were not statistically significant different for both OS and disease-free survival. Conclusion: In conclusion, CRS plus HIPEC remains an alternative to locoregional treatment in well-selected patients with PM in combination with systemic neoadjuvant and adjuvant chemotherapy. Keywords: Hyperthermic Intraperitoneal Chemotherapy (HIPEC), Cytoreductive Surgery (CRS), Peritoneal Metastasis (PM), Colorectal Cancer (CRC), adjuvant treatment
Cite This Article
John S, Dimitrios F, Theodoros M, Nikolaos - Jasonas S, Hayarpi S, Mairi G, et al. Role of Early Bedside HIPEC as Adjuvant Treatment in Colorectal Peritoneal Metastasis. EJMO. 2022; 6(4): 323-329
Corresponding Author: Spiliotis John