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Recurrences after peritoneal carcinomatosis of colorectal origin treated by cytoreduction and hyperthermic intraperitoneal chemotherapy : location, treatment, and outcome

Verwaal, Vic J ; Boot, Henk ; Aleman, Berthe M P ; van Tinteren, Harm and Zoetmulder, Frans A N (2004) In Annals of Surgical Oncology 11(4). p.9-375
Abstract

BACKGROUND: After treatment of peritoneal carcinomatosis of colorectal cancer origin by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC), recurrences develop in approximately 80% of patients. This study evaluates the outcome of such recurrences after initial treatment by cytoreduction and HIPEC.

METHODS: Between November 1995 and May 2003, 106 patients underwent cytoreduction and HIPEC. The progression-free interval, the location of the recurrence, and its treatment were recorded. Factors potentially related to survival after recurrences were studied.

RESULTS: Sixty-nine patients had a recurrence within the study period. For patients who had undergone a gross incomplete initial cytoreduction, the median... (More)

BACKGROUND: After treatment of peritoneal carcinomatosis of colorectal cancer origin by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC), recurrences develop in approximately 80% of patients. This study evaluates the outcome of such recurrences after initial treatment by cytoreduction and HIPEC.

METHODS: Between November 1995 and May 2003, 106 patients underwent cytoreduction and HIPEC. The progression-free interval, the location of the recurrence, and its treatment were recorded. Factors potentially related to survival after recurrences were studied.

RESULTS: Sixty-nine patients had a recurrence within the study period. For patients who had undergone a gross incomplete initial cytoreduction, the median duration of survival after recurrence was 3.7 months (standard error of the mean [SE], .3). If a complete cytoreduction had been accomplished initially, the median duration of survival after the recurrence was 11.1 months (SE, .9). A shorter interval between HIPEC and recurrence was associated with shorter survival after treatment of recurrence (hazard ratio, .94; SE, .02). After effective initial treatment, a second surgical debulking for recurrent disease resulted in a median survival duration of 10.3 months (SE, 1.9), and after treatment with chemotherapy it was 8.5 months (SE, 1.6). The survival was 11.2 months (SE, .5) for patients who received radiotherapy for recurrent disease. Patients who did not receive further treatment survived 1.9 months (SE, .3).

CONCLUSIONS: Treatment of recurrence after cytoreduction and HIPEC is often feasible and seems worthwhile in selected patients. Selection should be based mainly on the completeness of initial cytoreduction and the interval between HIPEC and recurrence.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Carcinoma/drug therapy, Chemotherapy, Adjuvant, Colorectal Neoplasms/drug therapy, Combined Modality Therapy, Female, Humans, Hyperthermia, Induced, Male, Middle Aged, Neoplasm Recurrence, Local, Peritoneal Neoplasms/secondary, Proportional Hazards Models, Prospective Studies, Survival Analysis, Treatment Outcome
in
Annals of Surgical Oncology
volume
11
issue
4
pages
9 - 375
publisher
Springer
external identifiers
  • pmid:15070596
  • scopus:3142655828
ISSN
1068-9265
DOI
10.1245/ASO.2004.08.014
language
English
LU publication?
no
id
13153502-ac43-496a-ac88-c6466532b1ee
date added to LUP
2022-04-12 10:49:49
date last changed
2024-06-04 03:46:02
@article{13153502-ac43-496a-ac88-c6466532b1ee,
  abstract     = {{<p>BACKGROUND: After treatment of peritoneal carcinomatosis of colorectal cancer origin by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC), recurrences develop in approximately 80% of patients. This study evaluates the outcome of such recurrences after initial treatment by cytoreduction and HIPEC.</p><p>METHODS: Between November 1995 and May 2003, 106 patients underwent cytoreduction and HIPEC. The progression-free interval, the location of the recurrence, and its treatment were recorded. Factors potentially related to survival after recurrences were studied.</p><p>RESULTS: Sixty-nine patients had a recurrence within the study period. For patients who had undergone a gross incomplete initial cytoreduction, the median duration of survival after recurrence was 3.7 months (standard error of the mean [SE], .3). If a complete cytoreduction had been accomplished initially, the median duration of survival after the recurrence was 11.1 months (SE, .9). A shorter interval between HIPEC and recurrence was associated with shorter survival after treatment of recurrence (hazard ratio, .94; SE, .02). After effective initial treatment, a second surgical debulking for recurrent disease resulted in a median survival duration of 10.3 months (SE, 1.9), and after treatment with chemotherapy it was 8.5 months (SE, 1.6). The survival was 11.2 months (SE, .5) for patients who received radiotherapy for recurrent disease. Patients who did not receive further treatment survived 1.9 months (SE, .3).</p><p>CONCLUSIONS: Treatment of recurrence after cytoreduction and HIPEC is often feasible and seems worthwhile in selected patients. Selection should be based mainly on the completeness of initial cytoreduction and the interval between HIPEC and recurrence.</p>}},
  author       = {{Verwaal, Vic J and Boot, Henk and Aleman, Berthe M P and van Tinteren, Harm and Zoetmulder, Frans A N}},
  issn         = {{1068-9265}},
  keywords     = {{Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Carcinoma/drug therapy; Chemotherapy, Adjuvant; Colorectal Neoplasms/drug therapy; Combined Modality Therapy; Female; Humans; Hyperthermia, Induced; Male; Middle Aged; Neoplasm Recurrence, Local; Peritoneal Neoplasms/secondary; Proportional Hazards Models; Prospective Studies; Survival Analysis; Treatment Outcome}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{9--375}},
  publisher    = {{Springer}},
  series       = {{Annals of Surgical Oncology}},
  title        = {{Recurrences after peritoneal carcinomatosis of colorectal origin treated by cytoreduction and hyperthermic intraperitoneal chemotherapy : location, treatment, and outcome}},
  url          = {{http://dx.doi.org/10.1245/ASO.2004.08.014}},
  doi          = {{10.1245/ASO.2004.08.014}},
  volume       = {{11}},
  year         = {{2004}},
}