Mitomycin-C versus oxaliplatin during cytoreductive surgery and HIPEC for peritoneal metastases secondary to colorectal carcinoma: a retrospective analysis.

PURPOSE: Combining cytoreductive surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) can benefit patients with peritoneal metastasis from colorectal cancer, however the optimal choice of the HIPEC chemotherapy is still under debate. The present study compares the clinical outcome in patients with peritoneal metastases treated with CRS and HIPEC using Mitomycin - C versus Oxaliplatin.

METHODS

We retrospectively analyzed patients that underwent CRS and HIPEC for recurrent colorectal cancer with peritoneal metastases. Patient characteristics, procedure details, and clinical outcomes were evaluated.

RESULTS

114 consecutive patients were included in the analysis (62 males - 52 females, mean age 58,3 years). The mean intraoperative PCI-score was 15.3 (range: 3 - 36). The mean follow-up period was 28.2 months. Patients receiving MMC - based HIPEC had significantly higher mean overall survival compared to oxaliplatin (54 versus 26 months), translated to a hazard ratio of 0.26 (95% CI 0.128 - 0.529, p<0.01). The HIPEC regimen as well as the completeness of cytoreduction were the only independent prognostic factors of survival in our sample.

CONCLUSIONS

Our results imply that the use of MMC offers a survival advantage over oxaliplatin when used for HIPEC in CRC PC. A randomised trial comparing oxaliplatin and MMC would enhance decision-making in such patients.