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.

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.