Research Article
Synchronous Liver Resection with Cytoreductive Surgery for the Treatment of Liver and Peritoneal Metastases from Colon Cancer: Results from an Australian Centre
Alzahrani N1,3*, Ung L1, Valle SJ1,2, Ferguson J1, Liauw W1,2 and Morris DL11Department of Surgery and St George Hospital Department of Surgical Oncology, University of New South Wales, Level 3, Pitney Clinical Sciences Building, Kogarah NSW 2217, Australia
2Cancer Care Centre, St George Hospital, 1 Short Street, Kogarah NSW 2217, Australia
3College Of Medicine, Imam Muhammed Ibn Saud Islamic University, Saudi Arabia
- *Corresponding Author:
- Dr. Nayef Alzahrani
St George Hospital Department of Surgical Oncology
Level 3, Pitney Clinical Sciences Building
Kogarah, NSW 2217, Australia
Tel: 61 432 639 166
Fax: 61 2 9113 3997
E-mail: nayefalhariri@hotmail.com
Received date: February 23, 2015; Accepted date: March 14, 2015; Published date: March 22, 2015
Citation: Alzahrani N, Ung L, Valle SJ, Ferguson J, Liauw W, et al. (2015) Synchronous Liver Resection with Cytoreductive Surgery for the Treatment of Liver and Peritoneal Metastases from Colon Cancer: Results from an Australian Centre. J Gastrointest Dig Syst 5:264. doi:10.4172/2161-069X.1000264
Copyright: © 2015 Alzahrani N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Treatment of peritoneal metastases (PM) and liver metastases (LM) from colon cancer remains controversial. LM has been viewed as exclusion criterion for cytoreductive surgery (CRS) on the basis that such spread represents systemic disease. CRS and intra-peritoneal chemotherapy (IPC) has gained increasing recognition as a treatment modality for selected patients with colon cancer and PM. This study analyses results of CRS and IPC for colon cancer and synchronous resection for treatment of LM and PM.
Methods: Seventy-eight patients with PM/LM colon cancer were analysed. Forty-two patients with PM were treated for disease limited to the peritoneum (A), and 36 patients received treatment for both PM and LM (B). Overall survival (OS), disease-free survival (DFS), morbidity, mortality, and recurrence were compared.
Results: Median overall (OS) and disease-free survival (DFS) was 32.8 and 13.5 months. The median OS for A and B were 45.5 and 24.4 months respectively. Within B patients, 18 had a PCI>7 and >3 LM and median survival of 21.8 months compared to 18 patients with PCI ≤ 7 and LM ≤ 3 with median survival of 38.4 months. Median DFS for A and B were 17.7 and 8.5 months respectively. Twenty-seven in total experienced major complications following surgery. Sixty-one patients recurred. Of A, 71.4% recurred compared to B at 86.1%.
Conclusion: While our study is limited, it has demonstrated encouraging evidence that long-term survival outcomes can be achieved in this small but significant number of patients treated by CRS/IPC and additional synchronous liver resection with no significant increase in morbidity when compared to CRS/IPC alone.
