Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal metastases

Table 2 Oncological outcome data n (%)

Ref.	Median FU (mth)	Pre-op CT	Post-op CT	Extent of cytoreduction/disease CCRS2	1-yr survival	2-yr survival	3-yr survival	4-yr survival	5-yr survival	Median survival (mo)	Local/distant recurrence
Portilla et al[33]	36.21	22% (regimen not stated)	100% (regimen not stated)	CC0-CC1 (14/18; 64)	CC0-CC1 (91%)	CC0-CC1 (64%)	-	-	-	Overall	-
				CC2-CC3 (4/18; 36)	CC2-CC3 (43%)	CC2-CC3 (14%)				20
				PCI < 12 (10/18; 56)	PC1 < 12 (N/A)	PCI < 12 (64%)
				PCI > 12 (8/18; 44)	PCI > 12 (N/A)	PCI > 12 (14%)
Witkamp et al[34]	38 (26-52)	-	72% (5-FU+ leucovorin)	-	82%	45%	23%	-	-	-	LR 28%
											DR 17%
											LR + DR 28%
Pilati et al[35]	14.5 (6-34)	0%	-	CC0-1 34/34	68%	31%	-	-	-	18	LR 59%
											DR 12%
											LR + DR 18%
Verwaal et al[36]	47.5 (1.3-88.3)	-	15% (leucovorin)	R1 (54/106; 51)	-	-	-	-	-	R1 11.1	Unspecified recurrence 65%
				R2a (37/106; 35)						R2a 5.9
				R2b (15/106; 14)						R2b 3.7
Glehen et al[37]	59.5	-	68% (5-FU + irinotecan leucovorin)	CC0 (23/53; 43)	CC0 85%	CC0 54%	-	-	CC0 22%	CC0 32.9	Unspecified recurrence 19%
				CC1 (11/53; 21)	CC1 46%	CC1 36%			CC1 9%	CC1 12.5
				CC2 (19/53; 36)	CC2 24%	CC2 0%				CC2 8.1
Mahteme et al[53]	-	-	-	CC0 (11/18; 61)	-	CRS + EPIC 60%	-	-	CRS + EPIC 28%	CRS + EPIC overall 32; CC0 34.5 CC1-2 10	-
				CC1-2 (7/18; 39)		Control arm 10%			Control arm 5%	Control arm: 14
Glehen et al[38]	53	54%	40%	CC0 (271/506; 54)	CC0 87%	-	CC0 47%	-	CC0 31%	Males	Unspecified recurrence 73%
				CC1 (106/506; 21)	CC1 79%		CC1 29%		CC1 15%	16.8
				CC2 (129/506; 25)	CC2 38%		CC2 6%		CC2 0%	Females
										21.6
Shen et al[39]	15 (3-85)	75%	-	R0 (13/77; 17)	-	-	R0 69%	-	R0 55%	R0 N/R	Unspecified recurrence 68%
				R1 (24/77; 31)			R1 19%		R1 19%	R1 17.8
				R2a (11/77; 14)			R2a 28%		R2a 14%	R2a 12.7
				R2b (9/77; 12)			R2b 0%		R2b 0%	R2b 4.1
				R2c (20/77; 26)			R2c 6%		R2c 0%	R2c 5.0
Cavaliere et al[40]	16	72%	-	CC0 (102/120; 85)	-	-	Overall	-	-	19	-
				CC1 (9/120; 7)			25.8%
				CC2-3 (9/120; 7)			CC0
							33.5%
Kianmanesh et al[41]	-	70%	75%	-	-	72%	-	44%		38.4	-
Gusani et al[42]	35.9 (19-57.7)	-	-	-	78%	37%	37%	-	-	15.2	-
Verwaal et al[26]	96 (72-115)	-	-	R1 (22/54; 41)	R1 95%	R1 80%	R1 58%	R1 52%	R1 45%	CRS + HIPEC	-
				R2a (23/54; 43)	R2a 65%	R2a 20%	R2a 10%	R2a 10%	R2a 10%	22.2
				R2b (9/54; 17)	R2b 22%	R2b 12%	R2b 0%	R2c 0%	R2c 0%	Systemic CT
										12.6
Yan[17]	14 (1-56)	-	-	CC0 (41/50; 82)	CC0 85%	-	CC0 62%	-	-	CC0 37	Unspecified recurrence 34%
				CC1-3 (9/50; 8)	CC1-3 51%		CC1-3 0%			CC1-3 14
Elias et al[54]	95.7	-	-	-	-	CRS + HIPEC	-	-	CRS + HIPEC	CRS + HIPEC	-
						81%			51%	62.7
						Systemic CT			Systemic CT	Systemic CT
						65%			13%	23.9
Varban et al[43]	14.6	-	-	-	-	HM 43.3%	-	HM 14.4%	-	HM 23	-
						No HM 36.8%		No HM 17.4%		No HM 15.8
Vaira et al[44]	-	55%	-	CC0 (29/40; 73)	CC0 88%	-	-	-	-	Overall: 43	-
				CC2 (11/40; 27)	CC2 42%					CC0: 24
										CC2: 9.7
Glehen et al[45]	-	-	-	-	81%	58%	39%	34%	28%	-	-
Franko et al[55]	-	100	-	-	CRS + HIPEC	CRS + HIPEC	CRS + HIPEC	CRS + HIPEC	CRS + HIPEC	CRS + HIPEC	-
					90%	65%	50%	42%	25%	34.7
					Systemic CT	Systemic CT	Systemic CT	Systemic CT	Systemic CT	Systemic CT
					55%	35%	12%	10%	7%	16.8
Quenet et al[46]	48.5	100%	-	CC0 (132/146; 90)	Overall	Overall	Overall	Overall	-	Overall	Unspecified recurrence 70%
				CC1 (12/146; 8)	92%	72%	55%	50%		41
				CC2 (2/146; 2)
Cashin et al[56]	HIPEC	HIPEC	HIPEC	-	HIPEC	HIPEC group	HIPEC group	HIPEC group	-	HIPEC group	-
	38	81%	38%		100%	78%	60%	48%		36.5
	EPIC	EPIC	EPIC		EPIC	EPIC group	EPIC group	EPIC group		EPIC group
	66	44%	38%		80%	48%	25%	17%		23.9
Passot et al[47]	58.5 (1-183)	75%	64.30%	CC0 (93/120; 78)	Overall	Overall	-	-	Overall	Overall	-
				CC1 (11/120; 9)	77%	51%			33%	36.2
				CC2 (16/120; 13)
Hompes et al[48]	22.7 (3.2-55.7)	-	62.50%	CC0 (48/48; 100)	OS 98%	OS 89%	-	-	-	-	-
					DFS 66%	DFS 46%
Cashin et al[57]	49 (0.5-100)	31%	18%	CC0 (97/151; 64)	HIPEC	HIPEC	HIPEC	HIPEC	-	HIPEC	-
				CC1-3 (54/151; 36)	80%	50%	27%	18%		34
					EPIC	EPIC	EPIC	EPIC		EPIC
					5%	-	-	-		25
Klaver et al[49]	10.5 (1-52)	-	-	CC0 (22/24; 92)	Overall	-	-	-	-	Overall	Unspecified recurrence 54%
				CC1 (2/24; 8)	83%					35
Turrini et al[50]	-	-	-	-	100%	-	51%	-	37%	-	-
Haslinger et al[51]	-	-	-	-	-	-	-	-	OS 38%	-	-
									PFS15%
Yonemura et al[52]	-	77%	-	CC0 (108/142; 76)	-	-	-	-	Overall	Overall	-
				CC1 34/142 (24)					23.4%	24.4
									CC0 20%	CC0 25.9
									CC1 9.9%	CC1 8

¹Peritoneal cancer index (PCI) - Calculated by combining lesion size (0-3; 0-no nodules present, 1-nodule(s) ≤ 5 mm diameter, 2-nodule(s) 5-50 mm in diameter, 3-nodule(s) ≥ 50 mm in diameter) with the abdominopelvic regions affected[33];

²Completeness of cytoreduction score (CCRS)[33]; CC0 No visible tumour remaining; CC1 residual tumour deposits < 2.5 mm in diameter; CC2 residual tumour deposits 2.5-25 mm in diameter; CC3 residual tumour deposits > 25 mm in diameter. HIPEC: Hyperthermic intraperitoneal chemotherapy; EPIC: Early post-operative intraperitoneal chemotherapy; CRS: Cytoreductive surgery; CT: Computed tomography.