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Background <p>Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has demonstrated improved overall survival (OS) and disease-free survival (DFS) in carefully selected patients with peritoneal metastases from colorectal cancer (CRC-PM). The primary aim of this retrospective study was to identify patients treated with CRS + HIPEC who achieved long-term survival and to analyze the factors most strongly associated with prolonged survival.</p> Methods <p>Among those eligible for CRS + HIPEC, a group of patients with adequate follow-up was evaluated and divided into two groups: the long-term survival group (OS &gt; 48&#xa0;months) and the average-term survival group (OS &lt; 48&#xa0;months). A comparative analysis was performed between the two groups to evaluate which factors might be associated with an increased likelihood of long-term survival. Propensity score matching (PSM) was employed to homogenize patients based on peritoneal cancer index (PCI) and extensive small bowel involvement. A further analysis was conducted to assess the differences in recurrence behavior between the two groups.</p> Results <p>During the study period, 116 patients underwent CRS + HIPEC. The median OS for the entire sample was 52&#xa0;months. Among the 63 patients with at least 4&#xa0;years of follow-up, 32 were identified as part of the average survival group (AS-G), while 31 were classified in the long-survival group (LS-G). DFS and survival after recurrence were statistically higher in the LS-G compared to the AS-G. Higher PCI, BRAF V600E mutation, right-sided primary tumor location, small bowel involvement, and mucinous histology were statistically more frequent in the AS-G compared to the LS-G. After PSM analysis, the absence of BRAF V600E mutation and the non-mucinous histology were significantly associated with long-term survival.</p> Conclusions <p>Long-term survival can potentially be achieved in patients with peritoneal metastasis from colorectal cancer (CRC) treated with CRS and HIPEC, often resulting in prolonged disease-free periods and less aggressive disease progression if recurrence occurs.</p>

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Evaluating long-term outcomes after cytoreductive surgery for colorectal peritoneal metastasis: do long survivors really exist?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月16日

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  • Giorgio D’Annibale,
  • Matteo Aulicino,
  • Carlo Abatini,
  • Cecilia Orsini,
  • Lorenzo Barberis,
  • Claudio Lodoli,
  • Miriam Attalla El Halabieh,
  • Andrea Di Giorgio,
  • Federica Ferracci,
  • Maria Alessandra Calegari,
  • Fabio Pacelli,
  • Francesco Santullo

摘要

Background

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has demonstrated improved overall survival (OS) and disease-free survival (DFS) in carefully selected patients with peritoneal metastases from colorectal cancer (CRC-PM). The primary aim of this retrospective study was to identify patients treated with CRS + HIPEC who achieved long-term survival and to analyze the factors most strongly associated with prolonged survival.

Methods

Among those eligible for CRS + HIPEC, a group of patients with adequate follow-up was evaluated and divided into two groups: the long-term survival group (OS > 48 months) and the average-term survival group (OS < 48 months). A comparative analysis was performed between the two groups to evaluate which factors might be associated with an increased likelihood of long-term survival. Propensity score matching (PSM) was employed to homogenize patients based on peritoneal cancer index (PCI) and extensive small bowel involvement. A further analysis was conducted to assess the differences in recurrence behavior between the two groups.

Results

During the study period, 116 patients underwent CRS + HIPEC. The median OS for the entire sample was 52 months. Among the 63 patients with at least 4 years of follow-up, 32 were identified as part of the average survival group (AS-G), while 31 were classified in the long-survival group (LS-G). DFS and survival after recurrence were statistically higher in the LS-G compared to the AS-G. Higher PCI, BRAF V600E mutation, right-sided primary tumor location, small bowel involvement, and mucinous histology were statistically more frequent in the AS-G compared to the LS-G. After PSM analysis, the absence of BRAF V600E mutation and the non-mucinous histology were significantly associated with long-term survival.

Conclusions

Long-term survival can potentially be achieved in patients with peritoneal metastasis from colorectal cancer (CRC) treated with CRS and HIPEC, often resulting in prolonged disease-free periods and less aggressive disease progression if recurrence occurs.