Vol.:(0123456789) 1 3
Clinical and Translational Oncology
https://doi.org/10.1007/s12094-019-02124-9
RESEARCH ARTICLE
Survival outcomes in patients aged 75 years and over with peritoneal
colorectal carcinomatosis after cytoreductive surgery
and hyperthermic intraperitoneal chemotherapy (HIPEC): multicenter
study of the Spanish Group of Peritoneal Cancer Surgery (GECOP)
P. A. Cascales‑Campos
1,2
· V. López‑López
1,2
· J. Torres‑Melero
3
· A. Arjona
4
· F. C. Muñoz‑Casares
4,5
· P. Barrios
6
·
R. Morales
7
· F. Pereira
8
· P. Bretcha‑Boix
9
· L. González‑Bayón
10
· S. González‑Moreno
11
· J. Gil
1,2
Received: 26 March 2019 / Accepted: 19 April 2019
© Federación de Sociedades Españolas de Oncología (FESEO) 2019
Abstract
Background The attitude toward cytoreductive surgery with HIPEC in peritoneal carcinomatosis from colorectal can-
cer is unclear. The aim of this study is to report the perioperative outcomes after cytoreductive surgery with HIPEC in
patients ≥ 75 years.
Methods This retrospective multicenter study collected the data the Spanish Group of Peritoneal Cancer Surgery. Thirty-six
patients with peritoneal carcinomatosis from colorectal cancer met the selection criteria for the study. Morbidity, mortality,
disease-free and overall survival were analyzed.
Results Morbidity (grade III–IV) was 17% and 2 patients died of complications related to the procedure (5.4%). Median
disease-free survival (DFS) was 16 months. DFS at 1 and 3 years was 81% and 42%, respectively. Overall survival at 1 and
3 years was 96% and 75%. In the univariate analysis, preoperative comorbidities (p = 0.01), liver metastases (p = 0.02), blood
transfusion (p = 0.001) and postoperative complications (p = 0.001); and in the multivariate analysis, perioperative blood
transfusion (OR 2.56, 95% CI 1.95–6.24, p = 0.03) and postoperative complications (OR 3.25, 95% CI 2.35–7.56, p = 0.02)
were associated with a lower overall survival.
Conclusions Age is not an absolute contraindication to perform cytoreduction surgery with HIPEC in highly selected elderly
patients with colorectal peritoneal carcinomatosis.
Keywords Elderly · Colorectal carcinomatosis · HIPEC · Morbidity · Survival
Introduction
Colorectal cancer is one of the most frequent solid tumors in
the Western world. Treatment options are dependent on disease
stage, the performance status of the patient, and increasingly
the molecular characteristics of the tumor. In countries with
screening programs, the incidence rate as well as the mortality
rate has gone down because of earlier tumor detection.
* P. A. Cascales-Campos
cascalescirugia@gmail.com
1
Hospital Clínico, Universitario Virgen De La
Arrixaca, Carretera Madrid-Cartagena S/N, El Palmar,
CP: 30120 Murcia, Spain
2
IMIB-Arrixaca, Murcia, Spain
3
Hospital Universitario De Torrecárdenas, Almería,
Andalucia, Spain
4
Hospital Universitario Reina Sofía, Córdoba, Andalucia, Spain
5
Present Address: Hospital Universtiario Virgen del Rocio,
Sevilla, Spain
6
Hospital De Sant Joan De Espi Moises Broggi,
Sant Joan De Espi, Cataluña, Spain
7
Hospital Universitario Son Espases, Palma de Mayorca,
Islas Baleares, Spain
8
Hospital Universitario De Fuenlabrada, Madrid, Spain
9
Hospital Quirón de Torrevieja, Alicante,
Comunidad Valenciana, Spain
10
Hospital General Universitario Gregorio Marañón, Madrid,
Spain
11
MD Anderson Cancer Center, Madrid, Spain