American journal of surgery · 2026
Patterns of referral for cytoreductive surgery and HIPEC among patients with metachronous peritoneal carcinomatosis and T4 colon cancer: A population-based study in Alberta, Canada.
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Oravec Nebojša, Stockley Cecily, Lee Jay, Taqi Kadhim, Ding Philip, Liu Ned, Cheung Winson, Mack Lloyd, Bouchard-Fortier Antoine
Аннотация
INTRODUCTION: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) can offer a survival benefit for patients with peritoneal carcinomatosis (PC) of colorectal origin. This retrospective study evaluated referral patterns for CRS-HIPEC in Alberta, Canada.
METHODS: Patients with T4a/b colon cancer diagnosed between 2018 and 2023 who developed isolated PC were identified using the Alberta Cancer Registry (ACR). Medical records were reviewed to assess natural history after diagnosis.
RESULTS: Of 791 patients with T4a/b colon cancer, 52 (6.57%) developed isolated PC, and 26 (50.0%) were referred for CRS-HIPEC. Referred patients had longer median overall survival (33.80 vs. 10.04 months, p<0.01), were younger (median age at diagnosis 56, vs 73 years, p < 0.01), and more likely to have received adjuvant systemic therapy (92.3% vs. 57.7%, p = 0.010). Of 26 non-referred patients, 10 (38.5%) had no clear contraindications to CRS-HIPEC CONCLUSION: Half of patients with PC of colorectal origin were not referred for CRS-HIPEC. Optimizing referral pathways may improve patient outcomes.
METHODS: Patients with T4a/b colon cancer diagnosed between 2018 and 2023 who developed isolated PC were identified using the Alberta Cancer Registry (ACR). Medical records were reviewed to assess natural history after diagnosis.
RESULTS: Of 791 patients with T4a/b colon cancer, 52 (6.57%) developed isolated PC, and 26 (50.0%) were referred for CRS-HIPEC. Referred patients had longer median overall survival (33.80 vs. 10.04 months, p<0.01), were younger (median age at diagnosis 56, vs 73 years, p < 0.01), and more likely to have received adjuvant systemic therapy (92.3% vs. 57.7%, p = 0.010). Of 26 non-referred patients, 10 (38.5%) had no clear contraindications to CRS-HIPEC CONCLUSION: Half of patients with PC of colorectal origin were not referred for CRS-HIPEC. Optimizing referral pathways may improve patient outcomes.