Comparison of cytoreductive surgery and resection of isolated peritoneal metastases in patients with peritoneal metastases from colorectal cancer: a retrospective study

Conflicts of Interest

Koya Hida has received a grant from Senko Medical Instrument Mfg. Co., Ltd. All the other authors have no conflict of interest to declare.

Source of Funding

Koya Hida has received a grant from The Japan Society

for the Promotion of Science (JSPS KAKENHI Grant Number: 16K10538) and Health Science Center.

Authors Contributions

Shinya Yoshida, Yasuyuki Kamada, Koya Hida, and

Kazuyuki Okada contributed to the study design and conceptualization. Shinya Yoshida and Satoshi Morita conducted

the statistical analysis. Koya Hida, Kazutaka Obama, Toshiyuki Kitai, and Yutaka Yonemura contributed to the interpretation of the results. All authors reviewed the draft of the

manuscript and conducted critical scrutiny. All authors have

approved the publication of the final version of the manuscript.

Approval by Institutional Review Board (IRB)

The protocol for this research project has been approved

by a suitably constituted Ethics Committee of the institution

in accordance with the Declaration of Helsinki. Kyoto University Graduate School and Faculty of Medicine Ethics

Committee, Approval No. (R2363). The need for informed

consent was waived using the opt-out method since this was

a retrospective observational study.

Data Sharing and Accessibility

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:

GLOBOCAN estimates of incidence and mortality worldwide for

99

J Anus Rectum Colon 2023; 7(2): 91-101

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

36 cancers in 185 countries. CA A Cancer J Clin. 2021 May; 71

(3): 209-49.

Koppe MJ, Boerman OC, Oyen WJ, Bleichrodt RP. Peritoneal carcinomatosis of colorectal origin: incidence and current treatment

strategies. Ann Surg. 2006 Feb; 243(2): 212-22.

Franko J, Shi Q, Goldman CD, et al. Treatment of colorectal peritoneal carcinomatosis With systemic chemotherapy: A pooled

analysis of North Central Cancer Treatment Group Phase III trials

N9741 and N9841. J Clin Oncol. 2012 Jan; 30(3): 263-67.

Franko J, Shi Q, Meyers JP, et al. Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an

analysis of individual patient data from prospective randomized

trials from the Analysis and Research in Cancers of the Digestive

System (ARCAD) database. Lancet Oncol. 2016 Dec; 17(12):

1709-719.

Klaver YL, Leenders BJ, Creemers GJ, et al. Addition of biological therapies to palliative chemotherapy prolongs survival in patients with peritoneal carcinomatosis of colorectal origin. Am J

Clin Oncol. 2013 Apr; 36(2): 157-61.

Sugarbaker PH. Peritonectomy procedures. Ann Surg. 1995 Jan;

221(1): 29-42.

Sugarbaker PH, Jablonski KA. Prognostic features of 51 colorectal

and 130 appendiceal cancer patients with peritoneal carcinomatosis

treated by cytoreductive surgery and intraperitoneal chemotherapy.

Ann Surg. 1995 Feb; 221(2): 124-32.

Verwaal VJ, van Ruth S, de Bree E, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus

systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003

Oct; 21(20): 3737-43.

Elias D, Blot F, El Otmany A, et al. Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy. Cancer. 2001 Jul; 92(1):

71-6.

Glehen O, Kwiatkowski F, Sugarbaker PH, et al. Cytoreductive

surgery combined With perioperative intraperitoneal chemotherapy

for the management of peritoneal carcinomatosis From colorectal

cancer: A multi-institutional study. J Clin Oncol. 2004 Aug; 22

(16): 3284-92.

Elias D, Lefevre JH, Chevalier J, et al. Complete cytoreductive

surgery plus intraperitoneal chemohyperthermia With oxaliplatin

for peritoneal carcinomatosis of colorectal origin. J Clin Oncol.

2009; 27(5): 681-5.

Elias D, Gilly F, Boutitie F, et al. Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy: retrospective analysis of 523 patients from a multicentric

French study. J Clin Oncol. 2010 Feb; 28(1): 63-8.

Glehen O, Gilly FN, Boutitie F, et al. Toward curative treatment of

peritoneal carcinomatosis from the nonovarian origin by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy: a multi-institutional study of 1,290 patients. Cancer.

2010 Dec; 116(24): 5608-18.

Yoshino T, Arnold D, Taniguchi H, et al. Pan-Asian adapted

ESMO consensus guidelines for the management of patients with

metastatic colorectal cancer: a JSMO-ESMO initiative endorsed by

CSCO, KACO, MOS, SSO, and TOS. Ann Oncol. 2018 Aug; 29

(1): 44-70.

Bushati M, Rovers KP, Sommariva A, et al. The current practice

of cytoreductive surgery and HIPEC for colorectal peritoneal me-

100

dx.doi.org/10.23922/jarc.2022-065

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

tastases: results of a WorldWide Web-based survey of the Peritoneal Surface Oncology Group International (PSOGI). Eur J Surg

Oncol. 2018 Dec; 44(12): 1942-8.

Hashiguchi Y, Muro K, Saito Y, et al. Japanese Society for Cancer

of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol. 2020 Apr; 25(1): 1-42.

Shida D, Yoshida T, Tanabe T, et al. Prognostic impact of R0 resection and targeted therapy for colorectal cancer with synchronous peritoneal metastasis. Ann Surg Oncol. 2018 Jun; 25(6):

1646-53.

Kobayashi H, Kotake K, Sugihara K. Impact of R0 resection for

synchronous peritoneal metastasis from colorectal cancer: A propensity score-matched analysis of a multi-institutional database.

Ann Gastroenterol Surg. 2021 Mar; 5(2): 221-7.

National Comprehensive Cancer Network. NCCN guidelines version 1.2022. [cited Mar 3 2022]. Available from: https://www.ncc

n.org/guidelines/guidelines-detail?category=1&id=1428

Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus

guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016 Aug; 27(8): 1386-422.

Kamada Y, Hida K, Ishibashi H, et al. Thirty-three long-term survivors after cytoreductive surgery in patients with peritoneal metastases from colorectal cancer: a retrospective descriptive study.

World J Surg Oncol. 2021 Dec; 19(1): 31.

Turaga K, Levine E, Barone R, et al. Consensus guidelines from

the American Society of Peritoneal Surface Malignancies on standardizing the delivery of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer patients in the United States.

Ann Surg Oncol. 2014 May; 21(5): 1501-5.

Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis.

Cancer Treat Res. 1996; 82: 359-74.

Gilly FN, Cotte E, Brigand C, et al. Quantitative prognostic indices in peritoneal carcinomatosis. Eur J Surg Oncol. 2006 Aug; 32

(6): 597-601.

Dindo D, Demartines N, Clavien PA. Classification of surgical

complications: a new proposal with evaluation in a cohort of 6336

patients and results of a survey. Ann Surg. 2004 Aug; 240(2): 20513.

Parikh MS, Johnson P, Romanes JP, et al. Cytoreductive surgery

and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases: A systematic review. Dis Colon Rectum. 2022

Jan; 65(1): 16-26.

Quénet F, Elias D, Roca L, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a

multicentre, randomized, open-label, phase 3 trial. Lancet Oncol.

2021 Feb; 22(2): 256-66.

Ha SH, Park SY, Park JS, et al. Short-term outcomes after laparoscopic cytoreductive surgery in patients with limited peritoneal

metastases from colorectal cancer. Surgery. 2019 Apr; 165(4): 77581.

Chua TC, Yan TD, Saxena A, et al. Should the treatment of peritoneal carcinomatosis by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy still be regarded as a highly morbid

procedure?: a systematic review of morbidity and mortality. Ann

Surg. 2009 Jun; 249(6): 900-7.

Supplementary Files

dx.doi.org/10.23922/jarc.2022-065

Supplementary Table 1. Patient characteristics in patients with a low

PCI (PCI<6).

Supplementary Table 2. Operative findings in patients with a low PCI

(PCI<6).

Supplementary Table 3. Postoperative complications, uni- and multivariable regression analysis in patients with a low PCI (PCI<6).

Supplementary Table 4. Overall survival, uni- and multivariable cox

regression in patients with a low PCI (PCI<6).

Supplementary Figure. Kaplan-Meier curve for overall survival comparing the patients with a low PCI (PCI<6) undergoing CRS-HIPEC (the

CRS group) and the patients undergoing RIPM (the RIPM group). PCI, peri-

CRS and RIPM in Patients with CRC-PM

toneal cancer index; CRS, cytoreductive surgery; HIPEC, hyperthermic intraperitoneal chemotherapy; RIPM, resection of isolated peritoneal metastases.

Please find supplementary file(s);

http://dx.doi.org/10.23922/jarc.2022-065

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