REPEAT CYTOREDUCTIVE SURGERY AND INTRAPERITONEAL INTRAOPERATIVE CHEMOTHERAPY IN THE TREATMENT OF PERITONEAL CARCINOMATOSIS RECURRENCE FROM COLORECTAL ORIGIN

AIM. To assess results of cytoreductive surgery (CRS) and intraperitoneal intraoperative chemotherapy (IIC) in patients with peritoneal carcinomatosis (PC) and PC recurrence (PCR) of colorectal origin. METHOD. 76 patients with PC were treated by cytoreductive surgery (CRS) and intraperitoneal chemotherapy with mitomycine C (20 mg/m²). In 57 (75 %) pts. carcinomatosis was synchronous. The median PCI - 3 (2; 6) (1-23). There were 15/76 (20 %) pts. with potentially resectable distant liver and lung metastases. RESULTS. Complications occurred in 15 (20 %) pts. Mortality rate was 1,3 %. The first PCR was developed in 34 (45 %) pts. The median time after first surgery -11 (9; 19) months. 19 (56 %) were underwent CRS with IIS and CC0 status was achieved in 18 cases. The second PCR registered in 8 (18) pts. after last CC0-resection Median time was 12 (6; 29) (2-37) months. In 6 (8) pts. CC0-operation was performed. The median disease-free survival (DFS) and overall survival (OS) was 20 and 36 months, respectively. The 1-, 3-, 5-year OS and DFS rate was 64 %, 31 %, n/d and 86 %, 48 %, 24 %, respectively. The median OS of patients operated for PCR was statistically significantly greater than nonoperativepatients with PCR - 37 and 26 months, respectively (p=0,029). CONCLUSION. Combined treatment approach for patients with PC from colorectal origin achieved low postoperative morbidity and mortality, and it provided good long-term survival in our experience.CRS with IIS in PCR is feasible in selected patients and improve survival rates.

carcinomatosis, carcinomatosis recurrence, colorectal cancer, cytoreductive surgery, intraperitoneal chemotherapy

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