• Hidde J Braam, Thijs R van Oudheusden, Ignace H J T de Hingh, Simon W Nienhuijs, Djamila Boerma, Marinus J Wiezer, and Bert van Ramshorst.
• Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
• J Surg Oncol. 2014 Jun 1; 109 (8): 841-7.

Background And ObjectivesCytoReductive Surgery (CRS) combined with Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) has an established role in the treatment of peritoneally metastasized colorectal cancer. The aim of the study was to describe the recurrence patterns and to evaluate treatment options and related survival.MethodsPatients treated with CRS + HIPEC in two tertiary referral centers between April 2005 and March 2013 were analyzed retrospectively. The prognostic value of several parameters was calculated using Cox Regression.ResultsOne hundred thirty two of 287 patients (46%) with peritoneal carcinomatosis treated with complete CRS and HIPEC were diagnosed with recurrent disease, after a median disease-free interval of 11.4 months. Recurrence were locoregional (43%), distant metastases (26%) or both (31%). Thirty-two of the 132 patients with recurrences (24%) were treated surgically with curative intent, which extended the median survival from 12 months to 43 months, compared to palliative treatment (best supportive care or chemotherapy; P < 0.001). Initial nodal status (P = 0.01) and the number of affected regions at initial CRS (P = 0.02) were significantly correlated to survival after disease recurrence.ConclusionDisease recurrence after CRS and HIPEC is common; in selected patients, an aggressive surgical approach may be beneficial and extend survival.© 2014 Wiley Periodicals, Inc.

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