Peritoneal metastases of colorectal origin treated by cytoreduction and HIPEC: An overview

Table 1 Peritoneal Surface Disease Severity Score

Symptomatology	PCI	Histology
No symptoms (0)	< 10 (1)	Well differentiated or moderately differentiated + N0 (1)
Moderate symptoms (1)	10-20 (3)	Moderately differentiated + N1 or N2 (3)
Severe symptoms (6)	> 20 (7)	Poorly differentiated or ring seal (9)

(): Score. Moderate symptoms is defined as weight loss of < 10%, moderate abdominal pain, ascites asymptomatic. Severe symptomatology is defined as weight loss of > 10%, pain that continues, intestinal obstruction, symptomatic ascites. PCI: Peritoneal Cancer Index (0-39). Histology of the primary tumor. N regional lymph node metastasis. Grade I: Summation result = (2-3); Grade II: (4-7); Grade III: 8-10; Grade IV: > 10.

Table 2 Survival outcomes of patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Ref.	Type of study	Year	n	Overall survival (mo)	Five-year survival	Overall morbidity1	Perioperative mortality
Verwaal et al[9]	RCT	2003	39	22	NR	NR	NR
Glehen et al[31]	RMS	2004	377	32	40%	22.9%	4%
da Silva et al[17]	RS	2006	70	33	32%	NR	NR
Kianmanesh et al[15]	RS	2007	30	38	44%	39%	2.3%
Bijelic et al[32]	RS	2008	49	33	20%	NR	NR
Shen et al[33]	RS	2008	121	34	26%	42%	5.5%
Yan et al[34]	RS	2008	50	29	NR	NR	NR
Elias et al[3]	CRS	2009	48	63	51%	NR	NR
Chua et al[19]	RS	2009	54	33	NR	NR	NR
Franko et al[28]	CRS	2010	67	34.7	26%	NR	NR
Elias et al[10]	RMS	2010	523	32	30%	31%	3%
Quenet et al[35]	PS	2011	146	41	41.8%	47.2%	4.1%
Ung et al[6]	RS	2013	211	46.8	42%	NR	NR

¹Morbidity data comes from different classifications and grades, so major morbidity might be lower in most cases. RCT: Randomized clinical trial; RMS: Retrospective multicenter study; RS: Retrospective Study; CRS: Comparative Retrospective Study; PS: Prospective Study; NR: Not reported.