Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study
Purpose The prognosis of peritoneal carcinomatosis (PC) from colorectal cancer has been improved with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, benefits of postoperative chemotherapy (CT) are unclear. Methods This retrospective, multicenter study inc...
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| Veröffentlicht in: | Annals of surgical oncology 2016-03, Vol.23 (3), p.863-869 |
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| creator | Maillet, Marianne Glehen, Olivier Lambert, Jerome Goere, Diane Pocard, Marc Msika, Simon Passot, Guillaume Elias, Dominique Eveno, Clarisse Sabaté, Jean-Marc Lourenco, Nelson André, Thierry Gornet, Jean-Marc |
| description | Purpose
The prognosis of peritoneal carcinomatosis (PC) from colorectal cancer has been improved with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, benefits of postoperative chemotherapy (CT) are unclear.
Methods
This retrospective, multicenter study included 231 patients treated by CRS and HIPEC for isolated PC of colon cancer in four expert’s centers. Overall survival (OS), progression-free survival (PFS), and peritoneal recurrence-free survival (PRFS) were compared between patients with adjuvant CT (started within 3 months after surgery) and patients with surveillance only.
Results
After exclusion of 10 patients for early postoperative death (4 %), 221 patients were included (CT group:
n
= 151; surveillance group:
n
= 70). Main postoperative CT regimens (median of 6 cycles) were Folfox (28 %), Folfiri bevacizumab (24.5 %), Folfiri (16 %), and Folfiri cetuximab (12.5 %). The median OS after surgery was 43.3 months with no difference between CT and surveillance groups. In multivariate analysis, a low peritoneal cancer index (
p
|
| doi_str_mv | 10.1245/s10434-015-4914-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1764702407</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1764702407</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-7d2c0db90d91f43aa1d5f6ca87bfb83c70b84ed2443822c0c658bc07f22aaf753</originalsourceid><addsrcrecordid>eNp1kcFu1TAQRS0EoqXwAWyQJTZsUmzHSfzYPUWFPqmISsA6cuwxdeXYwXYq5cv4PRy9UhUkVuPxnHtnpIvQa0rOKePN-0QJr3lFaFPxHeUVf4JOaVN-eCvo0_Imrah2rG1O0IuUbgmhXU2a5-iEtVwQwcUp-nUho1vxdUg5zBBltneA-xuYQr4p7bzivckQcR-m2UEuszWHCHpR2QaPpdf4ci3CjZ6swgefiwqizcGDdH9bmRDxIQUnM2h8_QiSUVkfJplDsgkHU9a54t5LryB-wHv8eXHZKvDbKV_zoteX6JmRLsGr-3qGvn-8-NZfVldfPh36_VWlOGe56jRTRI87onfU8FpKqhvTKim60YyiVh0ZBQfNOK8FK6hqGzEq0hnGpDRdU5-hd0ffOYafC6Q8TDYpcE56CEsaaNfyjjBOuoK-_Qe9DUv05bqNqmtWKFYoeqRUDClFMMMc7STjOlAybKkOx1SHkuqwpTrwonlz77yME-gHxZ8YC8COQCoj_wPio9X_df0NM6uxnA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1763322402</pqid></control><display><type>article</type><title>Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Maillet, Marianne ; Glehen, Olivier ; Lambert, Jerome ; Goere, Diane ; Pocard, Marc ; Msika, Simon ; Passot, Guillaume ; Elias, Dominique ; Eveno, Clarisse ; Sabaté, Jean-Marc ; Lourenco, Nelson ; André, Thierry ; Gornet, Jean-Marc</creator><creatorcontrib>Maillet, Marianne ; Glehen, Olivier ; Lambert, Jerome ; Goere, Diane ; Pocard, Marc ; Msika, Simon ; Passot, Guillaume ; Elias, Dominique ; Eveno, Clarisse ; Sabaté, Jean-Marc ; Lourenco, Nelson ; André, Thierry ; Gornet, Jean-Marc ; BIG-RENAPE Working Group</creatorcontrib><description>Purpose
The prognosis of peritoneal carcinomatosis (PC) from colorectal cancer has been improved with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, benefits of postoperative chemotherapy (CT) are unclear.
Methods
This retrospective, multicenter study included 231 patients treated by CRS and HIPEC for isolated PC of colon cancer in four expert’s centers. Overall survival (OS), progression-free survival (PFS), and peritoneal recurrence-free survival (PRFS) were compared between patients with adjuvant CT (started within 3 months after surgery) and patients with surveillance only.
Results
After exclusion of 10 patients for early postoperative death (4 %), 221 patients were included (CT group:
n
= 151; surveillance group:
n
= 70). Main postoperative CT regimens (median of 6 cycles) were Folfox (28 %), Folfiri bevacizumab (24.5 %), Folfiri (16 %), and Folfiri cetuximab (12.5 %). The median OS after surgery was 43.3 months with no difference between CT and surveillance groups. In multivariate analysis, a low peritoneal cancer index (
p
< 0.0001) and a long delay between diagnosis of CP and HIPEC (
p
= 0.001) were associated with increased OS. The median PFS and PRFS were 12.4 and 17 months, respectively. At 1 year, more patients were without progression (
p
= 0.001) or PC recurrence (0.0004) in the CT group, but with prolonged follow-up this difference was no longer significant.
Conclusions
Early postoperative CT does not improve OS after CRS and HIPEC for colon carcinomatosis. However, a transient effect on PFS and PRFS was observed. A subgroup of patients who may benefit more from CT remain to be defined.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-015-4914-4</identifier><identifier>PMID: 26480848</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Chemotherapy, Cancer, Regional Perfusion ; Colonic Neoplasms - pathology ; Colonic Neoplasms - therapy ; Colorectal Cancer ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Female ; Follow-Up Studies ; France - epidemiology ; Humans ; Hyperthermia, Induced ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Oncology ; Peritoneal Neoplasms - secondary ; Peritoneal Neoplasms - therapy ; Postoperative Complications - drug therapy ; Postoperative Complications - epidemiology ; Prognosis ; Retrospective Studies ; Surgery ; Surgical Oncology ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2016-03, Vol.23 (3), p.863-869</ispartof><rights>Society of Surgical Oncology 2015</rights><rights>Society of Surgical Oncology 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-7d2c0db90d91f43aa1d5f6ca87bfb83c70b84ed2443822c0c658bc07f22aaf753</citedby><cites>FETCH-LOGICAL-c442t-7d2c0db90d91f43aa1d5f6ca87bfb83c70b84ed2443822c0c658bc07f22aaf753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-015-4914-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-015-4914-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26480848$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maillet, Marianne</creatorcontrib><creatorcontrib>Glehen, Olivier</creatorcontrib><creatorcontrib>Lambert, Jerome</creatorcontrib><creatorcontrib>Goere, Diane</creatorcontrib><creatorcontrib>Pocard, Marc</creatorcontrib><creatorcontrib>Msika, Simon</creatorcontrib><creatorcontrib>Passot, Guillaume</creatorcontrib><creatorcontrib>Elias, Dominique</creatorcontrib><creatorcontrib>Eveno, Clarisse</creatorcontrib><creatorcontrib>Sabaté, Jean-Marc</creatorcontrib><creatorcontrib>Lourenco, Nelson</creatorcontrib><creatorcontrib>André, Thierry</creatorcontrib><creatorcontrib>Gornet, Jean-Marc</creatorcontrib><creatorcontrib>BIG-RENAPE Working Group</creatorcontrib><title>Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Purpose
The prognosis of peritoneal carcinomatosis (PC) from colorectal cancer has been improved with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, benefits of postoperative chemotherapy (CT) are unclear.
Methods
This retrospective, multicenter study included 231 patients treated by CRS and HIPEC for isolated PC of colon cancer in four expert’s centers. Overall survival (OS), progression-free survival (PFS), and peritoneal recurrence-free survival (PRFS) were compared between patients with adjuvant CT (started within 3 months after surgery) and patients with surveillance only.
Results
After exclusion of 10 patients for early postoperative death (4 %), 221 patients were included (CT group:
n
= 151; surveillance group:
n
= 70). Main postoperative CT regimens (median of 6 cycles) were Folfox (28 %), Folfiri bevacizumab (24.5 %), Folfiri (16 %), and Folfiri cetuximab (12.5 %). The median OS after surgery was 43.3 months with no difference between CT and surveillance groups. In multivariate analysis, a low peritoneal cancer index (
p
< 0.0001) and a long delay between diagnosis of CP and HIPEC (
p
= 0.001) were associated with increased OS. The median PFS and PRFS were 12.4 and 17 months, respectively. At 1 year, more patients were without progression (
p
= 0.001) or PC recurrence (0.0004) in the CT group, but with prolonged follow-up this difference was no longer significant.
Conclusions
Early postoperative CT does not improve OS after CRS and HIPEC for colon carcinomatosis. However, a transient effect on PFS and PRFS was observed. A subgroup of patients who may benefit more from CT remain to be defined.</description><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Chemotherapy, Cancer, Regional Perfusion</subject><subject>Colonic Neoplasms - pathology</subject><subject>Colonic Neoplasms - therapy</subject><subject>Colorectal Cancer</subject><subject>Combined Modality Therapy</subject><subject>Cytoreduction Surgical Procedures</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>France - epidemiology</subject><subject>Humans</subject><subject>Hyperthermia, Induced</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Peritoneal Neoplasms - therapy</subject><subject>Postoperative Complications - drug therapy</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kcFu1TAQRS0EoqXwAWyQJTZsUmzHSfzYPUWFPqmISsA6cuwxdeXYwXYq5cv4PRy9UhUkVuPxnHtnpIvQa0rOKePN-0QJr3lFaFPxHeUVf4JOaVN-eCvo0_Imrah2rG1O0IuUbgmhXU2a5-iEtVwQwcUp-nUho1vxdUg5zBBltneA-xuYQr4p7bzivckQcR-m2UEuszWHCHpR2QaPpdf4ci3CjZ6swgefiwqizcGDdH9bmRDxIQUnM2h8_QiSUVkfJplDsgkHU9a54t5LryB-wHv8eXHZKvDbKV_zoteX6JmRLsGr-3qGvn-8-NZfVldfPh36_VWlOGe56jRTRI87onfU8FpKqhvTKim60YyiVh0ZBQfNOK8FK6hqGzEq0hnGpDRdU5-hd0ffOYafC6Q8TDYpcE56CEsaaNfyjjBOuoK-_Qe9DUv05bqNqmtWKFYoeqRUDClFMMMc7STjOlAybKkOx1SHkuqwpTrwonlz77yME-gHxZ8YC8COQCoj_wPio9X_df0NM6uxnA</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Maillet, Marianne</creator><creator>Glehen, Olivier</creator><creator>Lambert, Jerome</creator><creator>Goere, Diane</creator><creator>Pocard, Marc</creator><creator>Msika, Simon</creator><creator>Passot, Guillaume</creator><creator>Elias, Dominique</creator><creator>Eveno, Clarisse</creator><creator>Sabaté, Jean-Marc</creator><creator>Lourenco, Nelson</creator><creator>André, Thierry</creator><creator>Gornet, Jean-Marc</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160301</creationdate><title>Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study</title><author>Maillet, Marianne ; Glehen, Olivier ; Lambert, Jerome ; Goere, Diane ; Pocard, Marc ; Msika, Simon ; Passot, Guillaume ; Elias, Dominique ; Eveno, Clarisse ; Sabaté, Jean-Marc ; Lourenco, Nelson ; André, Thierry ; Gornet, Jean-Marc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-7d2c0db90d91f43aa1d5f6ca87bfb83c70b84ed2443822c0c658bc07f22aaf753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Chemotherapy, Cancer, Regional Perfusion</topic><topic>Colonic Neoplasms - pathology</topic><topic>Colonic Neoplasms - therapy</topic><topic>Colorectal Cancer</topic><topic>Combined Modality Therapy</topic><topic>Cytoreduction Surgical Procedures</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France - epidemiology</topic><topic>Humans</topic><topic>Hyperthermia, Induced</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Peritoneal Neoplasms - secondary</topic><topic>Peritoneal Neoplasms - therapy</topic><topic>Postoperative Complications - drug therapy</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maillet, Marianne</creatorcontrib><creatorcontrib>Glehen, Olivier</creatorcontrib><creatorcontrib>Lambert, Jerome</creatorcontrib><creatorcontrib>Goere, Diane</creatorcontrib><creatorcontrib>Pocard, Marc</creatorcontrib><creatorcontrib>Msika, Simon</creatorcontrib><creatorcontrib>Passot, Guillaume</creatorcontrib><creatorcontrib>Elias, Dominique</creatorcontrib><creatorcontrib>Eveno, Clarisse</creatorcontrib><creatorcontrib>Sabaté, Jean-Marc</creatorcontrib><creatorcontrib>Lourenco, Nelson</creatorcontrib><creatorcontrib>André, Thierry</creatorcontrib><creatorcontrib>Gornet, Jean-Marc</creatorcontrib><creatorcontrib>BIG-RENAPE Working Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maillet, Marianne</au><au>Glehen, Olivier</au><au>Lambert, Jerome</au><au>Goere, Diane</au><au>Pocard, Marc</au><au>Msika, Simon</au><au>Passot, Guillaume</au><au>Elias, Dominique</au><au>Eveno, Clarisse</au><au>Sabaté, Jean-Marc</au><au>Lourenco, Nelson</au><au>André, Thierry</au><au>Gornet, Jean-Marc</au><aucorp>BIG-RENAPE Working Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2016-03-01</date><risdate>2016</risdate><volume>23</volume><issue>3</issue><spage>863</spage><epage>869</epage><pages>863-869</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Purpose
The prognosis of peritoneal carcinomatosis (PC) from colorectal cancer has been improved with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, benefits of postoperative chemotherapy (CT) are unclear.
Methods
This retrospective, multicenter study included 231 patients treated by CRS and HIPEC for isolated PC of colon cancer in four expert’s centers. Overall survival (OS), progression-free survival (PFS), and peritoneal recurrence-free survival (PRFS) were compared between patients with adjuvant CT (started within 3 months after surgery) and patients with surveillance only.
Results
After exclusion of 10 patients for early postoperative death (4 %), 221 patients were included (CT group:
n
= 151; surveillance group:
n
= 70). Main postoperative CT regimens (median of 6 cycles) were Folfox (28 %), Folfiri bevacizumab (24.5 %), Folfiri (16 %), and Folfiri cetuximab (12.5 %). The median OS after surgery was 43.3 months with no difference between CT and surveillance groups. In multivariate analysis, a low peritoneal cancer index (
p
< 0.0001) and a long delay between diagnosis of CP and HIPEC (
p
= 0.001) were associated with increased OS. The median PFS and PRFS were 12.4 and 17 months, respectively. At 1 year, more patients were without progression (
p
= 0.001) or PC recurrence (0.0004) in the CT group, but with prolonged follow-up this difference was no longer significant.
Conclusions
Early postoperative CT does not improve OS after CRS and HIPEC for colon carcinomatosis. However, a transient effect on PFS and PRFS was observed. A subgroup of patients who may benefit more from CT remain to be defined.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>26480848</pmid><doi>10.1245/s10434-015-4914-4</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Annals of surgical oncology, 2016-03, Vol.23 (3), p.863-869 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Antineoplastic Combined Chemotherapy Protocols - therapeutic use Chemotherapy, Cancer, Regional Perfusion Colonic Neoplasms - pathology Colonic Neoplasms - therapy Colorectal Cancer Combined Modality Therapy Cytoreduction Surgical Procedures Female Follow-Up Studies France - epidemiology Humans Hyperthermia, Induced Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Oncology Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Postoperative Complications - drug therapy Postoperative Complications - epidemiology Prognosis Retrospective Studies Surgery Surgical Oncology Survival Rate |
| title | Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study |
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