Cytoreductive Surgery of Colorectal Peritoneal Metastases: Outcomes after Complete Cytoreductive Surgery and Systemic Chemotherapy Only

被引:38
作者
Desolneux, Gregoire [1 ]
Maziere, Camille [1 ]
Vara, Jeremy [1 ]
Brouste, Veronique [2 ]
Fonck, Marianne [2 ]
Bechade, Dominique [2 ]
Becouarn, Yves [2 ]
Evrard, Serge [1 ,3 ]
机构
[1] Inst Bergonie, Digest Tumours Unit, Bordeaux, France
[2] Inst Bergonie, Clin & Epidemiol Res Unit, Bordeaux, France
[3] Univ Bordeaux, Bordeaux, France
来源
PLOS ONE | 2015年 / 10卷 / 03期
关键词
HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY; RANDOMIZED-TRIAL; CARCINOMATOSIS; CANCER; STANDARD; ORIGIN; MANAGEMENT; SURVIVAL; CARE;
D O I
10.1371/journal.pone.0122816
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Cytoreductive peritoneal surgery (CRS) associated with hyperthermic peritoneal chemotherapy (HIPEC) has long been considered the standard treatment for colorectal peritoneal metastases (CPM). However, although efficacy of surgery has been demonstrated, evidence supporting HIPEC's role is less certain. Method Overall survival (OS), progression-free survival (PFS) and morbidity were analysed retrospectively for fifty consecutively included patients treated for colorectal CPM with complete CRS and systemic chemotherapy only. Results Median peritoneal cancer index (PCI) was 8 (range 1-24). 23 patients had liver or lung metastases (LLM). 22 patients had synchronous CPM. 27 complications occurred (12 Grade 1/2, 14 Grade 3, 1 Grade 4a, 0 Grade 5). Median follow-up was 62.5 months (95 % CI 45.481.3), median survival 32.4 months (21.5-41.7). Three-and 5-year OS were 45.5% (0.31-0.59) and 29.64% (0.17-0.44) respectively. Presence of LLMs associated with peritoneal carcinomatosis was significantly associated with poorer prognosis, with survival at 5 years of 13.95% (95 % CI 2.9-33.6) vs. 43.87% (22.2-63.7) when no metastases were present (P=0.018). Median PFS was 9.5 months (95 % CI 6.2-11.1). Conclusion With an equivalent PCI range and despite one of the highest rates of LLM in the literature, our survival data of CRS + systemic chemotherapy only compare well with results reported after additional HIPEC. Tolerance was better with acceptable morbidity without any mortality. Extra-hepatic metastasis (LLM) is a strong factor of poor prognosis. Awaiting the results of the randomized PRODIGE trial, these results indicate that CRS + systemic chemotherapy only is a robust hypothesis to treat colorectal CPM.
引用
收藏
页数:12
相关论文
共 50 条
[31]   Impact of Molecular Status on Cytoreductive Surgery for Peritoneal Metastases from Colorectal Cancer [J].
Zhong, Yun ;
Yang, Keli ;
Qin, Xiusen ;
Luo, Rui ;
Wang, Hui .
CLINICS IN COLON AND RECTAL SURGERY, 2023, 36 (06) :415-422
[32]   Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal peritoneal metastases: analysis of short- and long-term outcomes [J].
Rosa, Fausto ;
Galiandro, Federica ;
Ricci, Riccardo ;
Di Miceli, Dario ;
Quero, Giuseppe ;
Fiorillo, Claudio ;
Cina, Caterina ;
Alfieri, Sergio .
LANGENBECKS ARCHIVES OF SURGERY, 2021, 406 (08) :2797-2805
[33]   Treatment of Isolated Peritoneal Recurrences in Patients with Colorectal Peritoneal Metastases Previously Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy [J].
van Eden, Wijntje J. ;
Elekonawo, Fortune M. K. ;
Starremans, Bas J. ;
Kok, Niels F. M. ;
Bremers, Andre J. A. ;
de Wilt, Johannes H. W. ;
Aalbers, Arend G. J. .
ANNALS OF SURGICAL ONCOLOGY, 2018, 25 (07) :1992-2001
[34]   Is Systemic Chemotherapy Useful in Patients Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Colorectal Peritoneal Metastases? A Propensity-Score Analysis [J].
Tonello, Marco ;
Baratti, Dario ;
Sammartino, Paolo ;
Di Giorgio, Andrea ;
Robella, Manuela ;
Sassaroli, Cinzia ;
Framarini, Massimo ;
Valle, Mario ;
Macri, Antonio ;
Graziosi, Luigina ;
Coccolini, Federico ;
Lippolis, Piero Vincenzo ;
Gelmini, Roberta ;
Deraco, Marcello ;
Biacchi, Daniele ;
Santullo, Francesco ;
Vaira, Marco ;
Di Lauro, Katia ;
D'Acapito, Fabrizio ;
Carboni, Fabio ;
Milone, Erica ;
Donini, Annibale ;
Fugazzola, Paola ;
Faviana, Pinuccia ;
Sorrentino, Lorena ;
Pizzolato, Elisa ;
Cenzi, Carola ;
Del Bianco, Paola ;
Sommariva, Antonio .
ANNALS OF SURGICAL ONCOLOGY, 2024, 31 (01) :594-604
[35]   Hyperthermic intraperitoneal chemotherapy following up-front cytoreductive surgery versus cytoreductive surgery alone for isolated synchronous colorectal peritoneal metastases: A retrospective, observational study [J].
Qin, Xiusen ;
Siyad Mohamed, Mohamed ;
Zhang, Yuanxin ;
Chen, Yuefang ;
Wu, Zhijie ;
Luo, Rui ;
Yi, Liang ;
Wang, Hui ;
Wang, Huaiming .
FRONTIERS IN ONCOLOGY, 2022, 12
[36]   Prognostic indicators for colorectal peritoneal metastases are different for patients with complete versus incomplete cytoreductive surgery [J].
Ghabra, Shadin ;
Chang, David ;
Sugarbaker, Paul H. .
JOURNAL OF SURGICAL ONCOLOGY, 2023, 128 (05) :860-868
[37]   Prognostic scores for colorectal cancer with peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy [J].
Enblad, M. ;
Ghanipour, L. ;
Cashin, P. H. .
INTERNATIONAL JOURNAL OF HYPERTHERMIA, 2018, 34 (08) :1390-1395
[38]   Intraperitoneal chemotherapy and cytoreductive surgery for peritoneal metastases coupled with curative treatment of colorectal liver metastases: an updated systematic review [J].
El-Nakeep, Sarah ;
Rashad, Noha ;
Oweira, Hani ;
Schmidt, Jan ;
Helbling, Daniel ;
Giryes, Anwar ;
Petrausch, Ulf ;
Mehrabi, Arianeb ;
Decker, Michael ;
Abdel-Rahman, Omar .
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY, 2017, 11 (03) :249-258
[39]   Prognostic Factors of Peritoneal Metastases from Colorectal Cancer following Cytoreductive Surgery and Perioperative Chemotherapy [J].
Yonemura, Yutaka ;
Canbay, Emel ;
Ishibashi, Haruaki .
SCIENTIFIC WORLD JOURNAL, 2013,
[40]   Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases: Where do we stand? [J].
Witmer, Hunter D. D. ;
Dhiman, Ankit ;
Turaga, Kiran K. .
CANCER, 2023, 129 (04) :495-502