Cytoreductive Sugery Combined With Intraperitoneal Chemotherapy To Cure Colorectal Peritoneal Metastasis —a Meta-analysis

Objective Analysis the effect and safty of cytoreductive sugery combined with intraperitoneal chemotherapy to cure colorectal peritoneal metastasis and try to select a more appropriate chemotherapy regimentMethod Selecting mainly large database Pubmed, Cochrane Library, Ovid, Wanfang for literature retrieval. Select those literature which compare cytorecutive sugery combined with intraperitoneal chemotherapy to cure colorectal peritoneal metastsis with traditional therapies.In addition,select those literature which compare Mytomycin C with Oxaplatin when doing intraperitoneal chemotherapy. We take the overall survival and the incidence of related complication as the main assessment indications.Result Eight trials are involved in the first comparable group. 684 patients are divided into two groups with CRS+IPC group(n=413) and control group(n =272). Compared to the control group,the overall survival of the CRS+IPC group is much higher with a total HR 0.46(95%CI 0.37-0.56;P<0.00001). Outcome is also the same when compared with CRS+SC group with a total HR 0.41(95%CI 0.28-0.60;P<0.0001). In CRS+SC group,the incidence of related complications such as hemorrhage,intestinal leakage,intestinal obstruction is higher than CRS_IPC group.whereas, the chemotherapy related side effects are less than CRS+IPC group with a total effect value OR 0.9(95%CI 0.56-1.45,P=0.67) which means the difference between the two groups is not statistically significant.Four case control literature are involved in the second comparable group. 780 patients are divided into two groups with Oxaliplatin group(n=253) and Mytomycin C group(n=527). Compared to MMC group,the overall survival of OX group is lower with a total effect value HR 1.39(95%CI 1.04-1.87;P=0.03). The differences of the incidence of complications between the two groups is not statistically significant with a total effect value OR 1.04(95%CI 0.50-2.20;P=0.91).Conclusion Although the study are not all RCTs, the data still support the assertion that multimodel treatment of CRS+IPC has a better outcome of overall survival compared with traditional therapies.Besides, MMC seems to have a better outcome of overall survival compared OX.