Cytoreductive Surgery Combined With Hyperthermic Intraperitoneal Chemotherapy For Peritoneal Carcinomatosis Of Colorectal Origin

Background: Peritoneal metastases from colorectal cancer are generally considered to be end-stage disease of colorectal cancer,which has a poor prognosis.In the past,this clinical situation was treated with palliative intent,and the median overall survival is only 5 to 7 months.In recent years,some studies have reported that cytoreductive surgery and hyperthermic intraperitoneal chemotherapy can significantly improve the prognosis of patients.This study aimed to provide a higher level of evidence based medicine through systematic review and meta-analysis.Objective: The aim of this study was to investigate the efficacy and safety of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy through systematic review and meta-analysis.Methods: Computer system to retrieve from January 2005 to January2019 between the English database PubMed,Embase,the Cochrane,Web of Sciences.A meta-analysis was performed to investigate the efficacy ofcytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for the treatment of colorectal cancer with peritoneal metastasis based on the outcomes of overall survival(OS).The included studies were evaluated for heterogeneity,publication bias,and quality,and odds ratio(OR)was calculated with a confidence interval estimated at 95%confidence interval(95% CI),and meta-analysis was performed using a random-effects models.Results: A total of nine studies were included in the analysis.A total of 2514 patients were included in the study,of them 1442 received cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy.Meta-analysis showed that 5-year survival of treatment group were significantly improved compared with control group.Conclusion: Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can improve patients’ survival.However,limited by the number and quality of included studies,the conclusions may be biased,and more high-quality randomized controlled trials and longer follow-up period are needed to confirm the benefit of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for peritoneal metastases from colorectal cancer.