Staged Laparoscopic Adjuvant Intraperitoneal Chemohyperthermia (IPCH) After Complete Resection for Locally Advanced Colorectal Or Gastric Cancer 5-year follow-up results

Elie K Chouillard, MD, Giusseppe Canonico, MD, Elias Chahine, MD, Abe L Fingerhut, MD


Introduction: Cytoreductive surgery followed by intraperitoneal chemohyperthermia (IPCH) is a promising treatment for patients with peritoneal malignancies. Usually, IPCH is performed concomitantly with cytoreductive surgery for peritoneal cancinomatosis (PC) or more occasionally as an adjuvant treatment after gastric resection for cancer. In this report, we describe the 5-year results of our preliminary experience with staged adjuvant laparoscopic IPCH after complete resection in patients with advanced colorectal or gastric cancer.

Methods and procedures: 25 patients underwent resection for colorectal (16 patients) or gastric cancer (9 patients) followed by staged laparoscopic IPCH. Operative technique, complications, as well as5-year follow-up findings were assessed. The homogeneity of the hyperthermia across the abdominal cavity was electronically maintained throughout the procedure by input and output flow regulation.

Results: Mean intraperitonel temperature was 41.9° C. One conversion to laparotomy was required (4 %). No major operative incident was encountered.

No mortality occurred in the 30-day postoperative period. The mean hospital stay was 12 days (9-23). Five patients developed complications (20 %). One patient was reoperated (4 %).

Mean follow-up was 66.5 months (60-79). Sixteen patients died including 14 of cancer related causes (distant metastases). 17 patients (68 %) had some form of second look laparoscopy or laparotomy and 4 patients had autopsy (16 %). All patients had PET scans every 6 months. Onepatient developed PC (4 %).

Conclusion: Staged laparoscopic adjuvant IPCH after open or laparoscopic resection in selected patients with colorectal or gastric cancer is safe and feasible. After more than 5-year follow-up, only 4 % seemed to have developed PC. Further evaluation of such approach is still needed

Session: Poster Presentation

Program Number: P554

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