Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Young Patients With Peritoneal Metastasis of Colorectal CancerdAn Asian Experience

Introduction: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are accepted treatment options for patients with cancers associated with the abdominal region. Currently, there are insufficient data that evaluate the effectiveness of these therapeutic options in young patients who have peritoneal metastasis (PM) origi-nating from colorectal cancer. Methods: In this investigation, we evaluated perioperative data, clinicopathological mani-festations, and survival consequences in 46 younger (<50 y) patients who underwent CRS and HIPEC therapy between 2017 June and 2019 June and then compared these data with 94 older patients (aged >50 y). Results: Compared with older patients, younger patients had a higher synchronous PM incidence (78.3% versus 51.1%, P < 0.001) and were more likely to exhibit signet ring his-tology and mucinous (29.8% versus 60.9%; P < 0.001). The cancer-specific survival rates after CRS and HIPEC treatment were similar in both age sets. Multivariate Cox regression revealed that mucinous/signet adenocarcinoma (hazard ratio 2.20, 95% confidence interval 1.02-4.74; P = 0.044) and rectal origin (hazard ratio 2.51, 95% confidence interval 1.11-5.67; P = 0.027) were independent risk factors for a lower cancer-specific survival rate. Conclusions: Younger (age <50 y) patients who have PM of colorectal cancer origin often present synchronous PM, which is less commonly observed in older patients. Tumors in younger patients are more aggressive; however, post-CRS and HIPEC treatment, the ben-efits are similar to those observed in older cohorts.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have similar effectiveness in treating peritoneal metastasis (PM) originating from colorectal cancer in both younger and older patients. Younger patients have a higher incidence of synchronous PM and more aggressive tumors. Mucinous/signet adenocarcinoma and rectal origin are independent risk factors for a lower cancer-specific survival rate.