Cytoreductive Surgery and HIPEC in Elderly Patient with Colorectal Cancer and Peritoneal Metastasis

Abstract

Background: Colorectal cancer (CRC) patients with peritoneal metastasis have the worst prognosis with a median overall survival of 4.1–8.5 months [1],[2]. Aim: To assess results in the elderly metastatic CRC patient with peritoneal dissemination treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin. Case Presented: Patient - 70-year-old female with metastatic CRC and peritoneal carcinomatosis. Prior to surgery, received 12 of chemotherapy FOLFOX + bevacizumab. CRS + HIPEC was performed followed by an uneventful recovery. After surgery, she has received chemotherapy with FOLFIRI. The disease progressed 14 months later. The patient has continued therapy with FOLFIRI, unfortunately, the disease has progressed and oral therapy with ftorafur has commenced. Patients’ overall survival so far is 48 months. Conclusions: Even though we cannot decisively distinguish if results are determined by CRS or additional HIPEC, the presented case shows the importance of a paradigm shift when peritoneal disease in selected patients is viewed as a regional disease rather than diffuse metastatic.