Results of Systematic Second-look Surgery Plus HIPEC in Asymptomatic Patients Presenting a High Risk of Developing Colorectal Peritoneal Carcinomatosis Neoadjuvant Chemotherapy with Bevacizumab May Improve Outcome after Cytoreduction and Hyperthermic Intraperitoneal Chemoperfusion (HIPEC) for Colorectal Carcinomatosis Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy with lobaplatin and docetaxel improves survival for patients with peritoneal carcinomatosis from abdominal and pelvic malignancies 8-Year Follow-up of Randomized Trial: Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy Versus Systemic Chemotherapy in Patients with Peritoneal Carcinomatosis of Colorectal Cancer A prospective multicenter phase II study evaluating multimodality treatment of patients with peritoneal carcinomatosis arising from appendiceal and colorectal cancer: the COMBATAC trial Peritoneal carcinomatosis of colorectal origin. Cytoreduction and heated intraperitoneal chemotherapy for colorectal cancer: are we excluding patients who may benefit? Simultaneous Parenchyma-Preserving Liver Resection, Cytoreductive Surgery and Intraperitoneal Chemotherapy for Stage IV Colorectal Cancer. Prognostic factors and oncologic outcome in 146 patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: Italian multicenter study S.I.T.I.L.O. Treatment of colorectal peritoneal carcinomatosis with systemic chemotherapy: a pooled analysis of north central cancer treatment group phase III trials N9741 and N9841. Peritoneal Surface Disease with Synchronous Hepatic Involvement Treated with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Is There a Possibility of a Cure in Patients With Colorectal Peritoneal Carcinomatosis Amenable to Complete Cytoreductive Surgery and Intraperitoneal Chemotherapy? Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy Complete cytoreductive surgery plus intraperitoneal chemohyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin.
Purpose : To analyze the impact of systematic second-look surgery plus hyperthermic intraperitoneal chemotherapy ( HIPEC ) performed 1 year after resection of the primary tumor in asymptomatic patients at high risk of developing peritoneal carcinomatosis ( PC ) . Patients and Methods : From 1999 to 2009 , 41 patients without any sign of recurrence on imaging studies underwent second-look surgery  aim ed at treating limited PC earlier and more easily . They were selected based on 3 primary tumor-associated criteria : resected minimal synchronous macroscopic PC ( n = 25 ) , synchronous ovarian metastases ( n = 8) , and perforation ( n = 8) . Results : PC was found and treated with complete surgery plus HIPEC in 23 of the 41 ( 56 % ) patients . The other patients underwent complete abdominal exploration plus systematic HIPEC . Median follow-up was 30 ( 9–109 ) months . One patient died postoperatively at day 69 . Grade 3 - 4 morbidity was low ( 9.7 % ) . The 5-year overall survival rate was 90 % and the 5-year disease-free survival rate was 44 % . Peritoneal recurrences occurred in 7 patients ( 17 % ) , 6 of whom had macroscopic PC discovered during the second-look ( 26 % ) , and one patient had no macroscopic PC ( 6 % ) . In the univariate analysis , the presence of PC at second-look surgery was a significant risk factor for recurrence ( P = 0.006 ) . Conclusion : Selection criteria for high-risk patients appear to be accurate . In these patients , the second-look strategy treated peritoneal carcinomatosis preventively or at an early stage , yielding promising results . This study has allowed us to design a multicentric r and omized trial ( comparing the second-look + HIPEC approach versus st and ard follow-up alone ) , which is beginning Background In selected patients with colorectal peritoneal carcinomatosis ( PC ) , cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemoperfusion ( HIPEC ) may improve survival . We aim ed to assess whether neoadjuvant chemotherapy with or without bevacizumab is indicated in this patient population . Methods Colorectal PC patients were treated with CRS and HIPEC using oxaliplatin ( 200–460 mg/m2 ) or mitomycin C ( 35 mg/m2 ) . Postoperative outcome and long-term survival were prospect ively recorded . The impact of clinical variables on overall survival ( OS ) was assessed using univariate and Cox multivariate analysis . Results Between October 2002 and May 2012 , 166 patients were treated with CRS and HIPEC . Neoadjuvant chemotherapy alone was administered to 21 % and neoadjuvant chemotherapy with bevacizumab to 16 % of patients . Postoperative mortality and major morbidity were 2.4 and 35 % , respectively . Half of the patients received adjuvant chemotherapy . After a median follow-up of 18 months , OS was 27 months ( 95 % confidence interval 20.8–33.2 ) . On univariate analysis , OS was associated with extent of disease ( P < 0.001 ) , neoadjuvant chemotherapy with bevacizumab ( P = 0.021 ) , completeness of cytoreduction ( CC ) ( P < 0.001 ) , and adjuvant chemotherapy ( P = 0.04 ) , but not with primary disease site , synchronous presentation , or chemoperfusion drug . In multivariate Cox regression , independent predictors of OS were CC ( hazard ratio 0.29 , P < 0.001 ) and neoadjuvant therapy containing bevacizumab ( hazard ratio 0.31 , P = 0.019 ) . Conclusions Long-term OS after CRS and HIPEC for colorectal cancer is associated with CC and neoadjuvant therapy containing bevacizumab . This regimen merits prospect i ve study in patients with resectable PC of colorectal origin Background This work was to evaluate the perioperative safety and efficacy of cytoreductive surgery ( CRS ) plus hyperthermic intraperitoneal chemotherapy ( HIPEC ) with lobaplatin and docetaxel in patients with peritoneal carcinomatosis ( PC ) from gastrointestinal and gynecological cancers . Methods Patients were treated by CRS + HIPEC with lobaplatin 50 mg/m2 and docetaxel 60 mg/m2 in 6000 mL of normal saline at 43 ± 0.5 ° C for 60 min . Vital signs were recorded for 6 days after CRS + HIPEC  procedures . Perioperative serious adverse events ( SAE ) , hematological , hepatic , renal , and electrolytes parameters , the changes in serum tumor markers ( TM ) before and after operation , patient recovery , and overall survival ( OS ) were analyzed . Results One hundred consecutive PC patients underwent 105 CRS + HIPEC procedures and postoperative chemotherapy .  The median CRS + HIPEC duration was 463 ( range , 245–820 ) min , and the highest temperature and heart rate during six postoperative days were 38.6 ° C ( median 37.5 ° C ) and 124 bpm ( median 100 bpm ) , respectively . The 30-day perioperative SAE occurred in 16 ( 15.2 % ) and mortality occurred in 2 ( 1.9 % ) patients . Most routine blood laboratory tests at 1 week after surgery turned normal . Among 82 cases with increased preoperative TM CEA , CA125 , and CA199 , 71 cases had TM levels reduced or turned normal . Median time to nasogastric tube removal was 5 ( range , 3–23 ) days , to liquid food intake 6 ( range , 4–24 ) days , and to abdominal suture removal 15 ( range , 10–30 ) days . At the median follow-up of 19.7 ( range , 7.5–89.2 ) months , the median OS was 24.2 ( 95 % CI , 15.0–33.4 ) months , and the 1- , 3- , and 5-year OS rates were 77.5 , 32.5 , and 19.8 % , respectively . Univariate analysis identified five independent prognostic factors on OS : the origin of PC , peritoneal cancer index , completeness of CRS , cycles of adjuvant chemotherapy , and SAE . Conclusions CRS + HIPEC with lobaplatin and docetaxel to treat PC is a feasible procedure with acceptable safety and can prolong the survival in selected patients with PC.Trial registration Clinical Trials.gov , Introduction The treatment of peritoneal carcinomatosis is based on cytoreduction followed by hyperthermic intraperitoneal chemotherapy and combined with adjuvant chemotherapy . In 2003 , a r and omized trial was finished comparing systemic chemotherapy alone with cytoreduction followed by hyperthermic intraperitoneal chemotherapy and systemic chemotherapy . This trial showed a positive result favoring the studied treatment . This trial has now been up date d to a minimal follow-up of 6 years to show long-term results . Patients and Methods For all patients still alive , the follow-up was up date d until 2007 . In the original study , four patients were excluded — two because of no eligible histology/pathology and two because of major protocol violations . After r and omization , four patients in the HIPEC arm and six in the control arm were not treated using the intended therapy , one patient because of withdrawal , one because of a life-threatening other malignant disease and the others because of progressive disease before initiation of the treatment . During the follow-up , one patient was crossed over from the control arm and underwent cytoreduction and HIPEC for recurrent disease , after the assigned treatment was completed . The data from these patients were censored at the moment of the cross-over . Progression-free and disease-specific survival were analyzed using the Kaplan Meyer test and compared using the log rank method . The long-term results were studied in more detail to evaluate efficacy and toxicity . Results At the time of this up date , the median follow-up was almost 8 years ( range 72–115 months ) . In the st and ard arm , 4 patients were still alive , 2 with and 2 without disease ; in the “ HIPEC ’ arm , 5 patients were still alive , 2 with and 3 without disease . The median progression-free survival was 7.7 months in the control arm and 12.6 months in the HIPEC arm ( P = 0.020 ) . The median disease-specific survival was 12.6 months in the control arm and 22.2 months in the HIPEC arm ( P = 0.028 ) . The 5-year survival was 45 % for those patients in whom a R1 resection was achieved . Conclusion With 90 % of all events having taken place up to this time , this r and omized trial shows that cytoreduction followed by HIPEC does significantly add survival time to patients affected by peritoneal carcinomatosis of colorectal origin . For a selected group , there is a possibility of long-term survival Background Peritoneal carcinomatosis is regarded as a common sign of advanced tumor stage , tumor progression or local recurrence of appendiceal and colorectal cancer and is generally associated with poor prognosis . Although survival of patients with advanced stage CRC has markedly improved over the last 20 years with systemic treatment , comprising combination chemotherapy + /− monoclonal antibodies , the oncological outcome —especially of the subgroup of patients with peritoneal metastases — is still unsatisfactory . In addition to systemic therapy , cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) are specific treatment options for a selected group of these patients and may provide an additional therapeutic benefit in the framework of an interdisciplinary treatment concept . Methods / design The COMBATAC trial is a prospect i ve , multicenter , open-label , single-arm , single-stage phase II trial investigating perioperative systemic polychemotherapy including cetuximab in combination with CRS and HIPEC patients with histologically proven wild-type KRAS colorectal or appendiceal adenocarcinoma and synchronous or metachronous peritoneal carcinomatosis . The planned total number of patients to be recruited is 60 . The primary endpoint is progression-free survival ( PFS ) . Secondary endpoints include overall survival ( OS ) , perioperative morbidity and treatment-associated toxicity , feasibility of the combined treatment regimen , quality of life ( QoL ) and histopathological regression after preoperative chemotherapy . Discussion The COMBATAC trial is design ed to evaluate the feasibility and efficacy of the combined multidisciplinary treatment regimen consisting of perioperative systemic combination chemotherapy plus cetuximab and CRS plus bidirectional HIPEC with intraperitoneal oxaliplatin . Trial registration Clinical Trials.gov Identifier : NCT01540344 , EudraCT number : 2009 - 014040 - PURPOSE Complete resection of macroscopic colorectal peritoneal carcinomatosis ( PC ) , followed by intraoperative intraperitoneal chemohyperthermia ( IPCH ) to treat residual microscopic disease achieves cure in some patients . We report long-term results concerning survival of a phase II study using oxaliplatin ( LOHP ) . PATIENTS AND METHODS From June 1998 to December 2003 , thirty patients with macroscopic colorectal PC underwent complete resection of PC followed by IPCH with LOHP performed in an open abdominal cavity . The dose of LOHP was 460 mg/m2 in 2 L/m2 of iso-osmotic 5 % dextrose , over 30 min at an intraperitoneally homogenous temperature of 43 degrees C and at a flow rate of 2 L/min in the continuous closed circuit . During the hour preceding IPCH , patients received 5-fluorouracil ( 400 mg/m2 ) and leucovorin ( 20 mg/m2 ) intravenously . All patients received neoadjuvant and adjuvant systemic chemotherapy . RESULTS Mean peritoneal tumor extension ( Sugarbaker 's Score ) was 14.3 + /- 3.8 , median operative duration , 450 min , and median blood loss , 940 mL. Eleven ( 37 % ) patients had associated extra-peritoneal lesions which were resected during the same procedure . There were no postoperative deaths and grade 2 - 3 morbidity ( requiring specific treatment ) was 40 % . Median follow-up was 55 months ( range : 31 - 84 ) . Twenty-two patients ( 73 % ) relapsed after a median interval of 14 months , but 7 of them ( 32 % ) were amenable to curative repeat surgery . At 3 and 5 years , overall survival rates ( 95 % confidence interval ) were 53 % ( 9 - 72 ) , and 48.5 % ( 31 - 66 ) respectively . At 3 and 5 years , disease-free survival rates were 41.5 % ( 27 - 59 ) , and 34 % ( 19 - 52 ) respectively . Median survival was 60.1 months . CONCLUSION When feasible , this treatment modality yields a 5-year survival rate of 48.5 % , with median survival attaining 60.1 months BACKGROUND Cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) are increasingly used to treat peritoneal carcinomatosis from colorectal cancer . It is still relatively unknown which poor prognostic factors to avoid in order to optimize patient selection for CRS + HIPEC . METHODS Between February 2003 and October 2011 , 68 consecutive colorectal cancer patients who underwent CRS + HIPEC with a complete cytoreduction were identified from a prospect i ve data base .  Survival analysis was performed using the Kaplan-Meier method , with log rank testing of differences between groups . Multivariate analysis was conducted using Cox proportional hazard regression . RESULTS Median follow-up was 30.3 ( range , 2 - 88 ) months amongst survivors . Patients with a peritoneal cancer index ( PCI ) of 10 or less showed improved survival over those with a PCI of 11 or higher ( P = 0.03 ) . No difference in survival was seen for the other potentially poor prognostic variables including lymph node status , synchronous peritoneal disease , peri-operative systemic chemotherapy , and rectal cancer primary . CONCLUSIONS A low PCI was associated with improved survival .  Complete CRS + HIPEC appears to result in similar survival outcomes regardless of delivery of peri-operative systemic chemotherapy . Rectal origin , lymph node status , and synchronous peritoneal disease should not be used as an absolute exclusion criteria for CRS + HIPEC based on current data BACKGROUND The outcome of stage IV colorectal cancer ( CRC ) has improved with modern systemic therapy . However , the concomitant presence of liver metastases ( LM ) and peritoneal carcinomatosis ( PC ) remains associated with a dismal prognosis and surgery in this context remains exceptional . METHODS Stage IV CRC patients with LM and PC undergoing simultaneous cytoreductive surgery , intraperitoneal chemotherapy ( IPC ) and liver resection/ablation were identified from prospect ively collected data bases . We assessed response to neoadjuvant chemotherapy ( NACT ) , postoperative complications , progression free survival ( PFS ) , and overall survival ( OS ) . RESULTS Twenty-one patients with resectable disease were treated between 2007 and 2014 . In 16 patients ( 76 % ) , NACT was administered and tumour response defined their selection . The remaining 5 ( 24 % ) were selected according to the pattern of recurrence . Median peritoneal cancer index was 5 ( range : 3 - 10.5 ) . Liver surgery included 34 wedge resections , 5 ablations and one bisectionectomy to treat a total of 45 hepatic lesions with a median of 2 per patient ( range : 1 - 2 ) and a median size of 1.35 cm ( range : 0.8 - 2 ) . Tumour regression grade 4 ( fibrosis but residual cancer cells predominate ) was seen in 50 % of the resected metastases after NACT . Median hospital stay was 17 days ( range : 14 - 24 ) ; severe morbidity ( Clavien-Dindo grade 3 - 4 ) occurred in 24 % and no perioperative mortality ( 0 - 90 days ) was recorded . The median OS was 44 months ( range : 31 - 57 ) while the median PFS was 10 months ( range : 8 - 12 ) . CONCLUSIONS Combined parenchyma-preserving liver resection , cytoreductive surgery and IPC in patients with LM and PC from CRC can be performed safely and results in promising mid-term overall survival AIM The present study was specifically design ed to assess the major clinical and pathological variables of patients with colorectal peritoneal carcinomatosis in order to investigate whether currently used criteria appropriately select c and i date s for peritonectomy procedures ( cytoreductive surgery ) combined with hyperthermic intraperitoneal chemotherapy ( HIPEC ) . PATIENTS AND METHODS Preoperative , operative and follow-up data on 146 consecutive patients presenting with peritoneal carcinomatosis of colorectal origin and treated by surgical cytoreduction combined with HIPEC in 5 Italian Hospital and University Centers were prospect ively entered in a common data base . Univariate and multivariate analyses were used to assess the prognostic value of clinical and pathologic factors . RESULTS Over a minimum 24-month follow-up , the overall morbidity rate was 27.4 % ( mortality rate : 2.7 % ) and was directly related to the extent of surgery . Peritoneal cancer index ( PCI ) , unfavorable peritoneal sites , synchronous or previously resected liver metastasis and the completeness of cytoreduction , all emerged as independent prognostic factors correlated with survival . CONCLUSIONS Until research provides more effective criteria for selecting patients based upon the biomolecular features of carcinomatosis , patients should be selected according to the existing independent prognostic variables PURPOSE Symptoms and complications of metastatic colorectal cancer ( mCRC ) differ by metastatic sites . There is a paucity of prospect i ve survival data for patients with peritoneal carcinomatosis colorectal cancer ( pcCRC ) . We characterized outcomes of patients with pcCRC enrolled onto two prospect i ve r and omized trials of  chemotherapy and contrasted that with other manifestations of mCRC ( non-pcCRC ) . METHODS A total of 2,095 patients enrolled onto two prospect i ve r and omized trials were evaluated for  overall survival ( OS ) and progression-free survival ( PFS ) . A Cox proportional hazard model was used to assess the adjusted associations . RESULTS The characteristics of the pcCRC group ( n = 364 ) were similar to those of the non-pcCRC patients in median age ( 63 v 61 years , P = .23 ) , sex ( 57 % males v 61 % , P = .23 ) , and performance status ( Eastern Cooperative Oncology Group performance status 0 or 1 94 % v 96 % , P = .06 ) , but differed in frequency of liver ( 63 % v 82 % , P < .001 ) and lung metastases ( 27 % v 34 % , P = .01 ) . Median OS ( 12.7 v 17.6 months , hazard ratio [ HR ] = 1.3 ; 95 % CI , 1.2 to 1.5 ; P < .001 ) and PFS ( 5.8 v 7.2 months , HR = 1.2 ; 95 % CI , 1.1 to 1.3 ; P = .001 ) were shorter for pcCRC versus non-pcCRC . The unfavorable prognostic influence of pcCRC remained after adjusting for age , PS , liver metastases , and other factors ( OS : HR = 1.3 , P < .001 ; PFS : HR = 1.1 , P = .02 ) . Infusional fluorouracil , leucovorin , and oxaliplatin was superior to irinotecan , leucovorin , and fluorouracil as a first-line treatment among pcCRC ( HR for OS = 0.62 , P = .005 ) and non-pcCRC patients ( HR = 0.66 , P < .001 ) . CONCLUSION pcCRC is associated with a significantly shorter OS and PFS as compared with other manifestations of mCRC . Future trials for mCRC should consider stratifying on the basis of pcCRC status Abstract Background Patients with peritoneal surface disease ( PSD ) often present with synchronous hepatic involvement ( HI ) . The impact of addressing the hepatic component during CRS/HIPEC on operative and survival outcomes is not clearly defined . Methods A prospect i ve data base of 1,067 procedures was review ed based on primary tumor , performance status , resection status , type of liver involvement ( superficial or parenchymal ) and hepatic resection , morbidity , mortality , and overall survival . Results There were 108 ( 10 % ) CRS/HIPEC procedures performed with synchronous liver debulking in 99 patients with PSD from 27 ( 33 % ) appendiceal and 32 ( 39 % ) colorectal primary lesions . Ninety percent of patients underwent subsegmental hepatic resection , whereas 22 % had disease with hepatic parenchymal involvement . Median intensive care unit ( ICU ) and hospital stay were 3.5 and 13.6 days , respectively . Clavien grade III/IV morbidity was similar for patients with or without resected HI ( 18.9 vs. 22.5 % ; p = 0.39 ) . The 30-day mortality rate was 6.5 and 2.8 % ( p = 0.07 ) for patients with and without resected HI , respectively . The median survival for all patients with low- grade appendiceal cancer was 42.1 months with resected HI and 95.5 months without HI ( p = 0.03 ) . Median survival for colorectal cancer patients after complete cytoreduction was 21.2 months with HI versus 33.6 months without HI ( p = 0.03 ) . Conclusions Synchronous resection of limited HI does not increase the morbidity or mortality of CRS/HIPEC procedures . The survival benefit , although still meaningful , was less for patients with HI . Resectable low volume HI in patients with PSD from colon and appendiceal primary lesions should not be considered a contraindication for CRS/HIPEC procedures Background : Although a r and omized trial demonstrated a survival benefit of cytoreductive surgery ( CRS ) and intraperitoneal chemotherapy ( IPC ) over systemic chemotherapy alone , the treatment of peritoneal carcinomatosis from colorectal cancer ( CRPC ) is still a matter of debate . The aims of this study were to evaluate long-term outcome after CRS and IPC and to identify the prognostic factors associated with a cure . Methods : Patients were considered cured if the disease-free survival interval lasted at least 5 years after the treatment of CRPC or its last recurrence . Patients who had died postoperatively , or from non – cancer-related deaths , or patients with a follow-up of less than 5 years since the last curative treatment were excluded from the analysis . Results : From 1995 to 2006 , 107 patients ( median age , 48 years ; range , 19–67 years ) underwent complete CRS , followed by IPC .  Postoperative complications occurred in 50 patients ( 53 % ) , including 4 postoperative deaths . After a median follow-up of 77 months ( range , 60–144 months ) , 5-year and 10-year overall survival rates were 35 % and 15 % , respectively . Seventeen patients ( 16 % ) were considered cured after a disease-free interval of at least 5 years , of whom 14 never developed a recurrence . Cured patients had a significantly lower median peritoneal cancer index than noncured patients , respectively 4 ( 3–16 ) and 12 ( 2–36 ) ( P = 0.0002 ) . In multivariate analysis , a peritoneal cancer index of 10 or less was the only independent factor predicting cure . Conclusions : The cure rate ( 16 % ) after complete CRS of colorectal peritoneal carcinomatosis , followed by IPC , in selected patients is close to that obtained after resection of colorectal liver metastases Peritoneal carcinomatosis ( PC ) is fatal , despite st and ard systemic chemotherapy . A new approach that combines maximal surgery with maximal regional chemotherapy has potential to cure selected patients who have colorectal PC . The authors have reported the oncologic results of this combined treatment PURPOSE To compare the long-term survival of patients with isolated and resectable peritoneal carcinomatosis ( PC ) in comparable groups of patients treated with systemic chemotherapy containing oxaliplatin or irinotecan or by cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy ( HIPEC ) . PATIENTS AND METHODS All patients with gross PC from colorectal adenocarcinoma who had undergone cytoreductive surgery plus HIPEC from 1998 to 2003 were evaluated . The st and ard group was constituted by selecting patients with colorectal PC treated with palliative chemotherapy during the same period , but who had not benefited from HIPEC because the technique was unavailable in the center at that time . RESULTS Forty-eight patients were retrospectively included in the st and ard group and were compared with 48 patients who had undergone HIPEC  and were evaluated prospect ively . All characteristics were comparable except age and tumor differentiation . There was no difference in systemic chemotherapy , with a mean of 2.3 lines per patient . Median follow-up was 95.7 months in the st and ard group versus 63 months in the HIPEC group . Two-year and 5-year overall survival rates were 81 % and 51 % for the HIPEC group , respectively , and 65 % and 13 % for the st and ard group , respectively . Median survival was 23.9 months in the st and ard group versus 62.7 months in the HIPEC group ( P < .05 , log-rank test ) . CONCLUSION Patients with isolated , resectable PC achieve a median survival of 24 months with modern chemotherapies , but only surgical cytoreduction plus HIPEC is able to prolong median survival to roughly 63 months , with a 5-year survival rate of 51 %
INTRODUCTION We aim ed to assess the efficacy and safety of delivering intraperitoneal chemotherapy and cytoreductive surgery for peritoneal metastases coupled with curative treatment of colorectal liver metastases .