Available online at www.sciencedirect.com
ScienceDirect EJSO 40 (2014) 366e367
www.ejso.com
Correspondence
Simultaneous surgical treatment for both colorectal liver metastases and peritoneal carcinomatosis
Dear Editor, We read with interest the paper written by Allard M.A et al.1 We disagree with the authors assertion that intraperitoneal chemotherapy (HIPEC) does not have a defined role in colorectal peritoneal carcinomatosis (PC) in the presence of liver metastases (LM). Many studies have demonstrated an improved survival in selected patients with both PC and LMs treated with cytoreductive surgery (CRS) and HIPEC. Colorectal PC was previously treated palliatively with a median survival of 6 months. Recently, the introduction of an aggressive approach, which combines complete cytoreductive surgery and intraperitoneal chemotherapy has led to a major improvement in the prognosis e reaching a survival of 20 months. Chua et al.2 has shown that LMs synchronously observed with PC have not been regarded as an absolute contraindication to CRS plus HIPEC. Chua’s comparative study demonstrated no significant survival difference in the treating of patients with both colorectal cancer PC and LMs compared to patients with isolated PC alone e reaching a 3 y overall survival (OS) of 60%. The number of LMs seems to be the only real prognostic factor. Elias3,4 identified three patients groups with a long-term prognosis: Patients with a good prognosis e those with a low PCI (
ScienceDirect EJSO 40 (2014) 366e367
www.ejso.com
Correspondence
Simultaneous surgical treatment for both colorectal liver metastases and peritoneal carcinomatosis
Dear Editor, We read with interest the paper written by Allard M.A et al.1 We disagree with the authors assertion that intraperitoneal chemotherapy (HIPEC) does not have a defined role in colorectal peritoneal carcinomatosis (PC) in the presence of liver metastases (LM). Many studies have demonstrated an improved survival in selected patients with both PC and LMs treated with cytoreductive surgery (CRS) and HIPEC. Colorectal PC was previously treated palliatively with a median survival of 6 months. Recently, the introduction of an aggressive approach, which combines complete cytoreductive surgery and intraperitoneal chemotherapy has led to a major improvement in the prognosis e reaching a survival of 20 months. Chua et al.2 has shown that LMs synchronously observed with PC have not been regarded as an absolute contraindication to CRS plus HIPEC. Chua’s comparative study demonstrated no significant survival difference in the treating of patients with both colorectal cancer PC and LMs compared to patients with isolated PC alone e reaching a 3 y overall survival (OS) of 60%. The number of LMs seems to be the only real prognostic factor. Elias3,4 identified three patients groups with a long-term prognosis: Patients with a good prognosis e those with a low PCI (
