Barbois, Sandrine
[UCL]
Léonard, Daniel
[UCL]
Souchet, A
[UCL]
Remue, Christophe
[UCL]
Abbes Orabi, Nora
[UCL]
Bachmann, Radu
[UCL]
Van den Eynde, Marc
[UCL]
Wittebole, Xavier
[UCL]
Cotte, E
[UCL]
Danse, Etienne
[UCL]
Mourin, Anne
[UCL]
Dragean, Cristina
[UCL]
Leclercq, Gisèle
[UCL]
Kartheuser, Alex
[UCL]
Introduction : Peritoneal carcinomatosis (PC) of colorectal origin remains the most advanced form of colorectal cancer and is still associated with poor outcome. Cytoreducive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) has deeply modified patients’ prognosis. Aim : This study aims to review our results of CRS and HIPEC based on Oxaliplatin and using a closed abdomen technique as treatment of peritonela carcinomatosis of colorectal origin. Beside oncologic outcome, this study examines the long term quality of life (QoL) of patients treated by CRS and HIPEC. Methods : This is a retrospective monocentric study based on consecutive patients presenting colorectal cancer with perioneal carcinomatosis and treated by CRS and HIPEC. Demographic, operative, post-operative and pathological data have been collected. Long term oncological results have been computed and quality of life has been evaluated using the EORTC QLQ C-30 and GIQLI questionnaires. Results : Between October 2007 and December 2015, 82 patients have undergone 92 HIPEC, of which 70 patients underwent 75 CS with Oxaliplatin HIPEC using a closed abdomen technique. Among the 38 patients alive at the time of the study, 34 had not benefited from a redo-HIPEC after December 31, 2015.Of the 82 patients operated between October 2007 and December 2015, 10 (10.9%) received prophylactic HIPEC. There were 44 women and 38 men with a median age of 60 (18-77). Twenty-one patients (32.6%) had synchronous resecable liver metastases. The median level of carcinoembryonic antigen was 2,7 ng / mL. The CC-0 and CC-1 resection scores were obtained for 75 (87.2%) and 10 (11.6%) procedures, respectively. The median index of peritoneal carcinomatosis (PCI) was 6 (0 to 30). Twenty-two patients (23.9%) had a Dindo-Clavien complication> 2 and the postoperative mortality was 1,6%. The median follow-up time is 35 months. Twenty-seven patients (29.3%) received neoadjuvant chemotherapy and 48 (53.3%) received adjuvant chemotherapy. Twelve patients (13.0%) had isolated recurrence of CP and 35 patients (38.0%) presented distant metastases. Overall survival (OS) and 5-year survival without recurrence (DFS) were 45.7% and 8.7%, respectively. The deterioration of the quality of life in the long term is related to the presence of an invasion and to the occurrence of distal recurrences. The EORTC and GIQLI questionnaires showed a high incidence and intensity of diarrhea. Conclusions : HIPEC with Oxaliplatin using a closed abdomen technique to treat CP of colorectal origin offers acceptable oncological results. This treatment strategy should therefore be considered for all patients with peritoneal carcinomatosis, while ensuring that patients live not only longer but also enjoy a good quality of life.
Bibliographic reference |
Barbois, Sandrine ; Léonard, Daniel ; Souchet, A ; Remue, Christophe ; Abbes Orabi, Nora ; et. al. Long term oncological results and quality of life after HIPEC for carcinomatosis of colorectal origin.Belgian Week of Gastroenterology - XXXth edition ((Belgium) Antwerp, du 21/02/2018 au 23/02/2018). |
Permanent URL |
http://hdl.handle.net/2078.1/193525 |