Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy with Intra-Operative Radiotherapy for Patients with Locally Advanced or Locally Recurrent Rectal Cancer and Peritoneal Metastases

Author:

van de Vlasakker Vincent C. J.1ORCID,van den Heuvel Teun B. M.1ORCID,Rijken Anouk1,Nienhuijs Simon W.1,Ketelaers Stijn H. J.1ORCID,Verrijssen An-Sofie E.2ORCID,Rutten Harm J.13,Nieuwenhuijzen Grard A. P.1,Burger Jacobus W. A.1,de Hingh Ignace H. J. T.134

Affiliation:

1. Department of Surgery, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands

2. Department of Radiotherapy, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands

3. GROW–School for Oncology and Reproduction, Maastricht University, 6211 LK Maastricht, The Netherlands

4. Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 19079, 3501 DB Utrecht, The Netherlands

Abstract

Purpose: To assess the safety and long-term outcome of a multimodality treatment consisting of radical surgery, intra-operative radiotherapy (IORT), and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for patients with locally advanced rectal cancer (LARC) or locally recurrent rectal carcinoma (LRRC) and peritoneal metastases (PM). Methods: The present study was a single-center cohort study, including all consecutive patients undergoing this treatment in a tertiary referral center for LARC, LRRC, and PM. Postoperative complications, intensive care stay (ICU stay), and re-admission rates were assessed as well as disease-free survival (DFS) and overall survival (OS). Results: A total of 14 LARC and 16 LRRC patients with PM were included in the study. The median ICU stay was 1 day, and 57% of patients developed a severe postoperative complication. No 90-day mortality was observed. Median DFS was 10.0 months (Interquartile Range 7.1–38.7), and median OS was 31.0 months (Interquartile Range 15.9–144.3). Conclusions: As postoperative complications and survival were in line with treatments that are accepted for LARC or LRRC and PM as separate procedures, we conclude that combined treatment with IORT and CRS-HIPEC should be considered as a treatment option for selected patients with LARC or LRRC and peritoneal metastases in tertiary referral centers.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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