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Annals of Surgical Oncology

, Volume 26, Issue 3, pp 845–851 | Cite as

More Synchronous Peritoneal Disease but Longer Survival in Younger Patients with Carcinomatosis from Colorectal Cancer Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

  • Daniel Solomon
  • Natasha L. DeNicola
  • Yael Feferman
  • Eliahu Bekhor
  • Marina L. Reppucci
  • Daniela Feingold
  • Samantha N. Aycart
  • Deepa R. Magge
  • Benjamin J. Golas
  • Daniel M. Labow
  • Umut SarpelEmail author
Gastrointestinal Oncology

Abstract

Background

Colonoscopy to detect colorectal cancer (CRC) is recommended starting at age 50 years; however, CRC rates are increasing in the prescreening population. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has been proven effective in select patients with peritoneal carcinomatosis (PC) from CRC, although it has not been evaluated specifically in patients < 50 years.

Methods

CRC patients aged < 50 years at diagnosis undergoing CRS/HIPEC 2007–2017 were compared with those aged ≥ 50 years. Age distribution was analyzed in patients undergoing colectomy alone versus CRS/HIPEC for CRC 1993–2013.

Results

A total of 98 patients underwent CRS/HIPEC, of which 44% were < 50 years. Younger patients were more likely to present with synchronous peritoneal metastases (p = 0.050). Receipt of perioperative chemotherapy was comparable (p = not significant [NS]). Charlson Comorbidity Index and ECOG score were similar (p = NS). Tumor grade was similar (p = NS). Peritoneal Carcinomatosis Index, total organs resected, and anastomoses created were comparable (p = NS). Major Clavien-Dindo morbidity and LOS were similar (p = NS). Younger patients survived longer after CRS/HIPEC (p = 0.011). Demographic data from patients undergoing colectomy (n = 225) and CRS/HIPEC (n = 98) showed that age < 50 years was increasingly common with the more aggressive procedure (9% and 44% respectively, p < 0.001).

Conclusions

Younger patients with PC from CRC presented more often with peritoneal metastases at the time of diagnosis. Yet despite similar perioperative features at CRS/HIPEC, they survived longer than older patients. Patients undergoing CRS/HIPEC are overall younger than those undergoing index colectomy.

Notes

Conflict of interest

The authors declare no potential conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Daniel Solomon
    • 1
  • Natasha L. DeNicola
    • 1
  • Yael Feferman
    • 1
  • Eliahu Bekhor
    • 1
  • Marina L. Reppucci
    • 1
  • Daniela Feingold
    • 1
  • Samantha N. Aycart
    • 1
  • Deepa R. Magge
    • 1
  • Benjamin J. Golas
    • 1
  • Daniel M. Labow
    • 1
  • Umut Sarpel
    • 1
    Email author
  1. 1.Division of Surgical Oncology, Department of SurgeryIcahn School of Medicine at Mount SinaiNew YorkUSA

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