A Preliminary Study On The Safety And Efficacy Of Hyperthermic Intraperitoneal Chemotherapy In Patients With CT4 Colorectal Cancer After Radical Resection

Background: Existing research results show that hyperthermic intraperitoneal chemotherapy(HIPEC)has a great clinical significance in preventing and treating colorectal cancer(CRC)recurrence and metastasis,and has improved their survival rate and quality of life.At present,the hyperthermic intraperitoneal chemotherapy is mostly used in patients with peritoneal carcinomatosis(PC)on colorectal cancer.However,the use of HIPEC was few in patients with colorectal cancer which had invaded the colorectal serosa or adjacent tissues during intraoperative exploration.The main risk factors for recurrence and metastasis of the abdominal cavity after radical colorectal cancer surgery are free cancer cells(FCC)and microcarcinoma(MC)in the abdominal cavity.Studies has shown that the number of free cancer cells that fall into the abdominal cavity is proportional to the T stage of the tumor.Intraperitoneal hyperthermic chemotherapy may reduce the incidence of peritoneal metastasis in patients with advanced colorectal cancer,such as cT4,who have had occult or potentially exfoliative cancer cells.Objective: In this study,patients diagnosed as cT4 colorectal cancer during the operation were enrolled.After complete resection of primary lesions and invasive tissues,the safety and preliminary efficacy of intraperitoneal hyperthermic chemotherapy for those patients were investigated.Methods: The data of patients diagnosed as cT4 colorectal cancer during the operation admitted to the second department of our hospital were analyzed.They were divided into the abdominal hyperthermic chemotherapy group(hyperthermic intraperitoneal chemotherapy and systemic vein chemotherapy)and the control group(systemic vein chemotherapy).The intraperitoneal hyperthermic chemotherapy group received intraperitoneal hyperthermic chemotherapy at 24-48 hours after operation.Postoperative adjuvant treatment was performed strictly in accordance with the norms in both groups The two groups underwent 6 cycles of Xelox chemotherapy in 1 month after operation.Follow-up observations were made on the differences in vital signs,incidence of complications and adverse reactions,CEA(Carcinoembryonic antigen)and CA199(Carbohydrate antigen199),living functional status,and recurrence and survival rates.Results: There was no difference in vital signs and length of hospital stay between the two groups.There was no significant difference in complications between the two groups.The living functional status in the HIPEC group was higher than the control group,P <0.05,and the difference was statistically significant.Within 6 months after operation,there was significant difference in the recurrence and metastasis rate between the two groups.3 month after HIPEC operation,the mean values of CEA and CA199 in HIPEC group was 3.66 ng/ml and 9.90 U/ml,and the mean values of CEA and CA199 in the control group was 4.73 ng/ml and 14.18 U/ml,with statistical significance.6 months after HIPEC operation,the mean values of CEA and CA199 in HIPEC group was 3.65 ng/ml and 11.35 U/ml,and the mean values of CEA and CA199 in the control group was 4.78ng/ml and 14.89 U/ml,with statistical significance.Conclusions: Early postoperative HIPEC can reduce the nutritional status of patients,but after symptomatic treatment,it does not increase the postoperative complications and toxic side effects of chemotherapy.Early postoperative HIPEC can reduce the abdominal recurrence and metastasis of patients after radical resection.Early postoperative HIPEC is clinically safe and feasible,and can improve the KPS score of patients.