Open Access Research article

Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified according to the retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin

Joerg OW Pelz1*, Terence C Chua2, Jesus Esquivel3, Alexander Stojadinovic4, Joerg Doerfer1, David L Morris2, Uwe Maeder1, Christoph-Thomas Germer1 and Alexander G Kerscher1

Author Affiliations

1 Department of General-, Visceral-, and Paediatric Surgery, University of Wuerzburg, Germany

2 UNSW Department of Surgery, St George Hospital, Sydney, NSW, Australia

3 Department of Surgical Oncology, St. Agnes Hospital, Baltimore, MD, USA

4 Department of Surgery, Walter Reed Army Medical Center and the United States Military Cancer Institute, Washington, USA

For all author emails, please log on.

BMC Cancer 2010, 10:689  doi:10.1186/1471-2407-10-689

Published: 22 December 2010

Abstract

Background

We evaluate the long-term survival of patients with peritoneal carcinomatosis (PC) treated with systemic chemotherapy regimens, and the impact of the of the retrospective peritoneal disease severity score (PSDSS) on outcomes.

Methods

One hundred sixty-seven consecutive patients treated with PC from colorectal cancer between years 1987-2006 were identified from a prospective institutional database. These patients either received no chemotherapy, 5-FU/Leucovorin or Oxaliplatin/Irinotecan-based chemotherapy. Stratification was made according to the retrospective PSDSS that classifies PC patients based on clinically relevant factors. Survival analysis was performed using the Kaplan-Meier method and comparison with the log-rank test.

Results

Median survival was 5 months (95% CI, 3-7 months) for patients who had no chemotherapy, 11 months (95% CI, 6-9 months) for patients treated with 5 FU/LV, and 12 months (95% CI, 4-20 months) for patients treated with Oxaliplatin/Irinotecan-based chemotherapy. Survival differed between patients treated with chemotherapy compared to those patients who did not receive chemotherapy (p = 0.026). PSDSS staging was identified as an independent predictor for survival on multivariate analysis [RR 2.8 (95%CI 1.5-5.4); p < 0.001].

Conclusion

A trend towards improved outcomes is demonstrated from treatment of patients with PC from colorectal cancer using modern systemic chemotherapy. The PSDSS appears to be a useful tool in patient selection and prognostication in PC of colorectal origin.