Intraperitoneal hyperthermic perfusion for recurrent colorectal cancer - Feasibility study

Because of the relative inefficiency of surgery and i.v. chemotherapy for peritoneal surface recurrence of cancer, a feasibility study to investigate other modes of therapy for efficacy was done. Eight patients with far advanced recurrent colorectal cancer, who failed surgery and systemic chemotherapy, were treated with a combination of surgery and intraperitoneal hyperthermic perfusion (IPHP) with mitomycin C. IPHP was applied by a dual-filter system with a subsequent heat exchanger driven by roller pumps. Perfusion was carried out at a patient temperature of 41°-45°C for 1 h using 6 l perfusate containing 10 mg/l mitomycin C. Response, defined as a decline of elevated carcinoembryonic antigen, occurred in eight of ten perfusions (duration: 6, 5, 4, 4, 4, 3, 1.5, 1 months). A longer duration of response occurred in patients with pseudomyxoma peritonei (6 months) and in those with multiple tumors smaller than 5 mm (4 months). Because of these encouraging patient responses, further studies should be conducted which, based on results of this study, will better select patients who have the type of disease most likely to respond to IPHP treatment. Also this might add another modality of therapy in the early postoperative period to increase treatment efficiency.