Clinical Study Of Postoperative Intraperitoneal Combined With Systemic Chemotherapy For Serosa-involved Colorectal Cancer

0bjective: Comparing clinical effect of postoperative intraperitoneal combined with systemic chemotherapy versus systemic chemotherapy alone for serosa-involved colorectal cancer.Methods: 814 patients with colorectal cancer underwent radical resection from January 2000 to January 2007. According to include criteria, 332 cases left and divided into 2 groups prospectively without randomization. Study group(n=166) was treated with combined chemotherapy, controlled group(n=166) got systemic chemotherapy alone. Incidence of local recurrence, peritoneal metastases, hepatic metastases, other distant metastases and 3-year, 5-year overall survival(OS) rate were analyzed.Results: 3-year and 5-year OS of stage IIB in study group and controlled group were 90.57%, 90.57% and 87.35%, 87.35% respectively (P=0.434). 3-year and 5-year OS of stage III in study group and controlled group were 86.50%,72.15% and 70.43%, 67.46% respectively (P=0.046). In study group, the 3-year and 5-year OS of patients underwent laparoscopic surgery and open surgery were 85.84%, 89.56% and 81.32%,81.87% respectively (P=0.839). And those in controlled group were 84.09%, 72.80% and 79.42%, 71.78% respectively (P=0.172). Incidence of local recurrence, peritoneal metastases and hepatic metastases between study group and controlled group were 1.8%, 3.6%, 3.6% vs. 7.8%, 9.0%, 9.6%, all with statistical significance. Other distant metastases rate in study group and controlled group were 4.8% and 3.6%(P=0.585). Median survival in patients with local recurrence, peritoneal metastases, hepatic metastases, and other distant metastases were 10.0 months, 4.5 months, 10.7 months, 15.8 months respectively. In study group, intraperitoneal chemotherapy regimen contained Oxaliplatin has lower rate of peritoneal metastases and hepatic metastases than those contained Cisplatin(8.8% vs. 0.92%, P=0.019), while incidence of local recurrence and other distant metastases were similar.Conclusion: Postoperative intraperitoneal chemotherapy combined with systemic chemotherapy improved 3-year and 5-year overall survival rate in patients with stage III serosa-involved colorectal cancer, and lowered local recurrence, peritoneal metastasis and liver metastasis rate, especially when intraperitoneal chemotherapy regimen contained Oxaliplatin.Comparing with open surgery, laparoscopic surgery didn't improved 3-year and 5-year overall survival rate in patient given combined chemotherapy or systemic chemotherapy alone.