Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Iterative cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases : A multi-institutional experience

Alzahrani, Nayef A ; Valle, Sarah J ; Fisher, Oliver M ; Sugarbaker, Paul H ; Yonemura, Yutaka ; Glehen, Olivier ; Goere, Dianne ; Honore, Charles ; Brigand, Cecile and de Hingh, Ignace , et al. (2019) In Journal of Surgical Oncology 119(3). p.336-346
Abstract

BACKGROUND AND OBJECTIVES: The aims of this multi-institutional study were to assess the feasibility of iterative cytoreductive surgery (iCRS)/hyperthermic intraperitoneal chemotherapy, iCRS in colorectal peritoneal carcinomatosis (CRPC), evaluate survival, recurrence, morbidity and mortality outcomes, and identify prognostic factors for overall survival.

METHODS: Patients with CRPC that underwent an iCRS, with or without intraperitoneal chemotherapy, from June 1993 to July 2016 at 13 institutions were retrospectively analyzed from prospectively maintained databases.

RESULTS: The study comprised of 231 patients, including 126 females (54.5%) with a mean age at iCRS of 51.3 years. The iterative high-grade (3/4) morbidity and... (More)

BACKGROUND AND OBJECTIVES: The aims of this multi-institutional study were to assess the feasibility of iterative cytoreductive surgery (iCRS)/hyperthermic intraperitoneal chemotherapy, iCRS in colorectal peritoneal carcinomatosis (CRPC), evaluate survival, recurrence, morbidity and mortality outcomes, and identify prognostic factors for overall survival.

METHODS: Patients with CRPC that underwent an iCRS, with or without intraperitoneal chemotherapy, from June 1993 to July 2016 at 13 institutions were retrospectively analyzed from prospectively maintained databases.

RESULTS: The study comprised of 231 patients, including 126 females (54.5%) with a mean age at iCRS of 51.3 years. The iterative high-grade (3/4) morbidity and mortality rates were 23.4% and 1.7%, respectively. The median recurrence-free survival was 15.0 and 10.1 months after initial and iCRS, respectively. The median and 5-year survivals were 49.1 months and 43% and 26.4 months and 26% from the initial and iCRS, respectively. Independent negative predictors of survival from the initial CRS included peritoneal carcinomatosis index (PCI) > 20 ( P = 0.02) and lymph node positivity ( P = 0.04), and from iCRS, PCI > 10 ( P = 0.03 for PCI 11-20; P < 0.001 for PCI > 20), high-grade complications ( P = 0.012), and incomplete cytoreduction ( P < 0.001).

CONCLUSION: iCRS can provide long-term survival benefits to highly selected colorectal peritoneal carcinomatosis patients with comparable mortality and morbidity rates to the initial CRS procedure. Careful patient selection is necessary to improve overall outcomes.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
author collaboration
publishing date
type
Contribution to journal
publication status
published
keywords
Adolescent, Adult, Aged, Chemotherapy, Cancer, Regional Perfusion/mortality, Colorectal Neoplasms/mortality, Combined Modality Therapy, Cytoreduction Surgical Procedures/mortality, Female, Follow-Up Studies, Humans, Hyperthermia, Induced/mortality, Male, Middle Aged, Neoplasm Recurrence, Local/mortality, Peritoneal Neoplasms/mortality, Prognosis, Prospective Studies, Retrospective Studies, Survival Rate, Young Adult
in
Journal of Surgical Oncology
volume
119
issue
3
pages
336 - 346
publisher
Wiley-Blackwell
external identifiers
  • scopus:85058572933
  • pmid:30554404
ISSN
0022-4790
DOI
10.1002/jso.25277
language
English
LU publication?
no
additional info
© 2018 Wiley Periodicals, Inc.
id
efe8e2ba-6f7e-4c86-bb68-091c35e782f2
date added to LUP
2022-04-04 17:12:19
date last changed
2024-04-22 14:26:21
@article{efe8e2ba-6f7e-4c86-bb68-091c35e782f2,
  abstract     = {{<p>BACKGROUND AND OBJECTIVES: The aims of this multi-institutional study were to assess the feasibility of iterative cytoreductive surgery (iCRS)/hyperthermic intraperitoneal chemotherapy, iCRS in colorectal peritoneal carcinomatosis (CRPC), evaluate survival, recurrence, morbidity and mortality outcomes, and identify prognostic factors for overall survival.</p><p>METHODS: Patients with CRPC that underwent an iCRS, with or without intraperitoneal chemotherapy, from June 1993 to July 2016 at 13 institutions were retrospectively analyzed from prospectively maintained databases.</p><p>RESULTS: The study comprised of 231 patients, including 126 females (54.5%) with a mean age at iCRS of 51.3 years. The iterative high-grade (3/4) morbidity and mortality rates were 23.4% and 1.7%, respectively. The median recurrence-free survival was 15.0 and 10.1 months after initial and iCRS, respectively. The median and 5-year survivals were 49.1 months and 43% and 26.4 months and 26% from the initial and iCRS, respectively. Independent negative predictors of survival from the initial CRS included peritoneal carcinomatosis index (PCI) &gt; 20 ( P = 0.02) and lymph node positivity ( P = 0.04), and from iCRS, PCI &gt; 10 ( P = 0.03 for PCI 11-20; P &lt; 0.001 for PCI &gt; 20), high-grade complications ( P = 0.012), and incomplete cytoreduction ( P &lt; 0.001).</p><p>CONCLUSION: iCRS can provide long-term survival benefits to highly selected colorectal peritoneal carcinomatosis patients with comparable mortality and morbidity rates to the initial CRS procedure. Careful patient selection is necessary to improve overall outcomes.</p>}},
  author       = {{Alzahrani, Nayef A and Valle, Sarah J and Fisher, Oliver M and Sugarbaker, Paul H and Yonemura, Yutaka and Glehen, Olivier and Goere, Dianne and Honore, Charles and Brigand, Cecile and de Hingh, Ignace and Verwaal, Vic J and Deraco, Marcello and Baratti, Dario and Kusamura, Shigeki and Pocard, Mark and Piso, Pompiliu and Maerz, Loreen and Marchal, Frederic and Moran, Brendan and Levine, Edward A and Dumont, Frédéric and Pezet, Denis and Abboud, Karine and Kozman, Mathew A and Liauw, Winston and Morris, David L}},
  issn         = {{0022-4790}},
  keywords     = {{Adolescent; Adult; Aged; Chemotherapy, Cancer, Regional Perfusion/mortality; Colorectal Neoplasms/mortality; Combined Modality Therapy; Cytoreduction Surgical Procedures/mortality; Female; Follow-Up Studies; Humans; Hyperthermia, Induced/mortality; Male; Middle Aged; Neoplasm Recurrence, Local/mortality; Peritoneal Neoplasms/mortality; Prognosis; Prospective Studies; Retrospective Studies; Survival Rate; Young Adult}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{336--346}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Surgical Oncology}},
  title        = {{Iterative cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases : A multi-institutional experience}},
  url          = {{http://dx.doi.org/10.1002/jso.25277}},
  doi          = {{10.1002/jso.25277}},
  volume       = {{119}},
  year         = {{2019}},
}