Treatment of synchronous peritoneal carcinomatosis and liver metastases from colorectal cancer

Aim To report our experience of peritoneal carcinomatosis (PC) discovered during abdominal exploration in patients with liver metastases (LM). Methods Liver resection plus cytoreductive surgery were combined in 24 patients with LM and moderate PC from colorectal origin treated with a curative intent between January 1993 and November 2003. Results The mean operative time was 357 ± 112 min and median blood loss was 719 ml. One postoperative death occurred and postoperative morbidity was 58%. The mean hospital stay was 21.4 ± 4.2 days. Three-year overall and disease-free survival rates were respectively 41.5% (confidence interval [CI]: 23–63) and 23.6% (CI: 11–45). Seven patients are disease-free with a mean follow-up of 27.8 months after their last surgery, 3 having a repeated hepatectomy. Three patients developed a peritoneal recurrence and 13 had recurrence in the liver. The only significant prognostic factor was a number of LMs of less than 3 (p < 0.01). Conclusion A combined treatment of LM plus PC is feasible and is beneficial in selected patients presenting three or fewer metastases.