72196 - Outcome is not associated with advanced age after CRS and HIPEC for Colorectal peritoneal metastases: a population-based study

Introduction Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has entailed better prognosis and overall survival for patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, data on perioperative complications and long-term survival of this procedure in elderly patients (≥75 years) are scarce. The aim of this study was to determine if age ≥75 impacts overall survival (OS) and postoperative morbidity. Method This population-based study collected data from the National Swedish HIPEC Registry, including patients with PM from CRC operated with CRS-HIPEC. We stratified patients by age (≤74 vs ≥75) with overall survival as primary outcome. Secondary outcomes included PCI-score, N-stage, postoperative morbidity, early mortality and time to relapse. Result A total of 592 patients were identified of which 553 were ≤74 year whereas 39 were ≥75. There was no difference in OS (p=0.951, Fig. 1). Factors affecting OS negatively were CC-1 (p=0.004), PCI ≥20 (p=0.009), nodal status N2 (p=0.041), but not age ≥75. No difference was noted for time to relapse (p=0.525) and in case of recurrent disease, curative intention was offered more frequently to patients ≤69 years (p=0.045). Serious postoperative complication (Clavien-Dindo grade III-IV) rate was 27% in patients ≤74 year and 21% in patients ≥75. The in-hospital mortality rate was 1.3% in patients ≤74 year and zero in patients ≥75year. No difference was observed in in-hospital morbidity (p=0.540) or reoperations (p=0.749). Discussion These results support that advanced age is not a contraindication to perform CRS-HIPEC in selected patients with PM from CRC.