Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology Surgical

Incidence: according to GLOBOCAN 2018, the worldwide incidence rate of colorectal cancer reached 1.8 million cases/year and mortality rates reached 9.2%. It is considered the third and second most common cancer in men and women respectively. In 10%-35% of patients with recurrent Colorectal Cancer (CRC) tumor recurrence is confined to the peritoneal cavity. Those patients have been shown to ultimately die from complications of loco regional tumoral widespread, in most cases without occurrence of metastases in other sites. Aim of the study: determine the oncological effectiveness of adjuvant Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in preventing the development of Peritoneal Carcinomatosis in Colorectal Cancer (PCCRC) in high risk cases (those with minimal serosal involvement) following a colectomy with the intention to treat. Methods: This is a pilot study done by randomizing an eligible group of 21 CRC patients (in a 1:1 ratio) undergoing a curative colectomy and minimal Cytoreductive Surgery (CRS) at the National Cancer Institute (NCI), Cairo University (CU) to adjuvant HIPEC followed by standard adjuvant systemic chemotherapy in the experimental arm, or adjuvant systemic chemotherapy alone in the standard treatment arm. The effectiveness of adjuvant HIPEC was determined by the Peritoneal-Recurrence Free Survival (PRFS) among both groups at 18 months based on routine follow-up visits, CT imaging, CEA and CA19-9 as biochemical markers.Results: Median follow-up period was 16 months (ranged from 2 to 18 months). The median PRFS was 16 months and the cumulative PRFS at 12 months (1year) was 52.4%, and at 18 months was 30.6% for the whole study group. Among the 10 patients in the experimental arm, peritoneal recurrence developed in 5/10 patients (50%), while in the standard treatment arm 9 out of the 11 patients (81%) developed peritoneal recurrence

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