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Results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy after early failure of adjuvant systemic chemotherapy

Klaver, Yvonne L B ; de Hingh, Ignace H J T ; Boot, Henk and Verwaal, Victor J LU (2011) In Journal of Surgical Oncology 103(5). p.4-431
Abstract

BACKGROUND AND OBJECTIVES: Failure to respond to systemic chemotherapy is considered an exclusion criterion by some institutions for treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). However, it is unknown if these patients benefit from HIPEC treatment. This study aimed to report on outcomes of HIPEC in patients who failed to respond to adjuvant systemic chemotherapy.

METHODS: Patients were selected from a prospective database containing data on all patients who underwent HIPEC, using the following criteria: (1) Metachronous peritoneal carcinomatosis (PC) from colorectal origin, (2) adjuvant chemotherapy after primary tumor resection, (3) development of PC or local recurrence within 18... (More)

BACKGROUND AND OBJECTIVES: Failure to respond to systemic chemotherapy is considered an exclusion criterion by some institutions for treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). However, it is unknown if these patients benefit from HIPEC treatment. This study aimed to report on outcomes of HIPEC in patients who failed to respond to adjuvant systemic chemotherapy.

METHODS: Patients were selected from a prospective database containing data on all patients who underwent HIPEC, using the following criteria: (1) Metachronous peritoneal carcinomatosis (PC) from colorectal origin, (2) adjuvant chemotherapy after primary tumor resection, (3) development of PC or local recurrence within 18 months after start of chemotherapy. Treatment and survival data were retrospectively collected.

RESULTS: Twenty-one patients (29% male, mean age 57 years) were included. Median time to recurrence of disease was 9 months (range 2-15) after first chemotherapy administration. Median survival was 28 months (range 3-100). One- and 2-year survival were 71% and 43%, respectively.

CONCLUSIONS: Patients who initially failed to respond to systemic adjuvant treatment showed a survival after HIPEC similar to results reported in literature in patients with unknown responsiveness. Failure to respond to previous adjuvant systemic treatment should therefore not be considered an exclusion criterion for HIPEC treatment.

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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Capecitabine, Colorectal Neoplasms/mortality, Combined Modality Therapy, Deoxycytidine/administration & dosage, Female, Fluorouracil/administration & dosage, Follow-Up Studies, Humans, Hyperthermia, Induced, Infusions, Parenteral, Leucovorin/administration & dosage, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Recurrence, Local/diagnosis, Neoplasm Staging, Organoplatinum Compounds/administration & dosage, Oxaliplatin, Peritoneal Neoplasms/mortality, Prospective Studies, Retrospective Studies, Survival Rate, Treatment Outcome
in
Journal of Surgical Oncology
volume
103
issue
5
pages
4 - 431
publisher
Wiley-Blackwell
external identifiers
  • scopus:79952583663
  • pmid:21400529
ISSN
0022-4790
DOI
10.1002/jso.21836
language
English
LU publication?
no
additional info
Copyright © 2010 Wiley-Liss, Inc.
id
43cf9dbb-953a-497f-8b4b-096f6b0e994c
date added to LUP
2022-04-05 11:16:54
date last changed
2024-01-03 04:34:37
@article{43cf9dbb-953a-497f-8b4b-096f6b0e994c,
  abstract     = {{<p>BACKGROUND AND OBJECTIVES: Failure to respond to systemic chemotherapy is considered an exclusion criterion by some institutions for treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). However, it is unknown if these patients benefit from HIPEC treatment. This study aimed to report on outcomes of HIPEC in patients who failed to respond to adjuvant systemic chemotherapy.</p><p>METHODS: Patients were selected from a prospective database containing data on all patients who underwent HIPEC, using the following criteria: (1) Metachronous peritoneal carcinomatosis (PC) from colorectal origin, (2) adjuvant chemotherapy after primary tumor resection, (3) development of PC or local recurrence within 18 months after start of chemotherapy. Treatment and survival data were retrospectively collected.</p><p>RESULTS: Twenty-one patients (29% male, mean age 57 years) were included. Median time to recurrence of disease was 9 months (range 2-15) after first chemotherapy administration. Median survival was 28 months (range 3-100). One- and 2-year survival were 71% and 43%, respectively.</p><p>CONCLUSIONS: Patients who initially failed to respond to systemic adjuvant treatment showed a survival after HIPEC similar to results reported in literature in patients with unknown responsiveness. Failure to respond to previous adjuvant systemic treatment should therefore not be considered an exclusion criterion for HIPEC treatment.</p>}},
  author       = {{Klaver, Yvonne L B and de Hingh, Ignace H J T and Boot, Henk and Verwaal, Victor J}},
  issn         = {{0022-4790}},
  keywords     = {{Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Capecitabine; Colorectal Neoplasms/mortality; Combined Modality Therapy; Deoxycytidine/administration & dosage; Female; Fluorouracil/administration & dosage; Follow-Up Studies; Humans; Hyperthermia, Induced; Infusions, Parenteral; Leucovorin/administration & dosage; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local/diagnosis; Neoplasm Staging; Organoplatinum Compounds/administration & dosage; Oxaliplatin; Peritoneal Neoplasms/mortality; Prospective Studies; Retrospective Studies; Survival Rate; Treatment Outcome}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{4--431}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Surgical Oncology}},
  title        = {{Results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy after early failure of adjuvant systemic chemotherapy}},
  url          = {{http://dx.doi.org/10.1002/jso.21836}},
  doi          = {{10.1002/jso.21836}},
  volume       = {{103}},
  year         = {{2011}},
}