Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases in an elderly population: outcomes from a single centre

Flood, MP; Narasimhan, V; Waters, PS; Kong, JC; Ramsay, R; Michael, M; Tie, J; McCormick, JJ; Warrier, SK; Heriot, AG

Author(s): Flood, MP; Narasimhan, V; Waters, PS; Kong, JC; Ramsay, R; Michael, M; Tie, J; McCormick, JJ; Warrier, SK; Heriot, AG;
Details: Publication Year 2022-09,Volume 92,Issue #9,Page 2192-2198
Journal Title: ANZ Journal of Surgery
Publication Type: Research article
Abstract: BACKGROUND: The prevalence of elderly patients with resectable colorectal peritoneal metastases (CRPM) is increasing. This study aimed to compare short and long-term outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for CRPM in patients above and below 70 years of age. METHODS: This was a retrospective, 10-year analysis of 90-day major morbidity and mortality, and long-term survival. RESULTS: Thirty-two (21.3%) of 150 consecutive patients who underwent CRS and HIPEC during the study period were aged 70 and older. PCI (P = 0.04), perioperative chemotherapy use (P < 0.01) and organ resections (rectum P = 0.04, diaphragm P = 0.03) were less in the over 70 group. There was no significant differences in major morbidity (P = 0.19) and mortality (P = 0.32). There was also no difference in 5-year overall survival (OS) (>/=70: 26% vs. <70: 39%; P = 0.68) and disease-free survival (DFS) (>/=70: 25% vs. <70: 14%; P = 0.22). Age above 70 was not independently associated with worse OS (HR 1.55, P = 0.20) and DFS (HR 1.07, P = 0.81). CONCLUSION: The surgical management of CRPM appears safe and feasible in this elderly population. Appropriate selection of elderly patients for such radical intervention is reinforced by the comparable survival with those under 70.
Keywords: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; *Colorectal Neoplasms/pathology; Combined Modality Therapy; Cytoreduction Surgical Procedures; Humans; *Hyperthermia, Induced; Hyperthermic Intraperitoneal Chemotherapy; *Percutaneous Coronary Intervention; *Peritoneal Neoplasms/secondary; Retrospective Studies; Survival Rate; colorectal peritoneal metastases; cytoreductive surgery; elderly; morbidity
Department(s): Surgical Oncology; Laboratory Research; Medical Oncology
PubMed ID: 35531885
Publisher's Version: https://doi.org/10.1111/ans.17761
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-24 06:56:09

Last Modified: 2024-10-24 06:56:36