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

Vincent C.J. van de Vlasakker, Teun B.M. van den Heuvel, Anouk Rijken, Simon W. Nienhuijs, Stijn H.J. Ketelaers, An Sofie E. Verrijssen, Harm J. Rutten, Grard A.P. Nieuwenhuijzen, Jacobus W.A. Burger, Ignace H.J.T. de Hingh (Corresponding author)

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3 Citations (Scopus)

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.

Original languageEnglish
Article number858
Number of pages10
JournalCancers
Volume15
Issue number3
DOIs
Publication statusPublished - Feb 2023
Externally publishedYes

Funding

De Hingh reports an unrestricted research grant from RanD/QPS and Roche, outside the submitted work, paid to the institute. The other authors have no conflict of interest to declare.

FundersFunder number
Roche Diagnostics

    Keywords

    • colorectal neoplasms
    • CRS-HIPEC
    • cytoreduction
    • intro operative radiotherapy
    • IORT
    • LARC
    • locally advanced rectal cancer
    • locally recurrent rectal cancer
    • LRRC
    • peritoneal metastases
    • surgical procedures

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