CRS and HIPEC in patients with peritoneal metastasis secondary to colorectal cancer: The small-bowel PCI score as a predictor of survival.
Hyperthermic IntraPeritoneal Chemotherapy (HIPEC)
PCI score
colorectal cancer
cytoreductive surgery
small bowel
Journal
Pleura and peritoneum
ISSN: 2364-768X
Titre abrégé: Pleura Peritoneum
Pays: Germany
ID NLM: 101710063
Informations de publication
Date de publication:
01 Dec 2019
01 Dec 2019
Historique:
received:
23
06
2019
accepted:
24
09
2019
entrez:
5
12
2019
pubmed:
5
12
2019
medline:
5
12
2019
Statut:
epublish
Résumé
Combining cytoreductive surgery (CRS) with Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) can benefit patients with peritoneal metastasis from colorectal cancer. The present study evaluates the small bowel subset of the Peritoneal Cancer Index (Small-Bowel-PCI score (SB-PCI), min-max 0-12) as a prognostic factor in such patients. We retrospectively analyzed patients that underwent CRS and HIPEC for recurrent colorectal cancer with peritoneal metastasis. Patient characteristics, procedure details, and clinical outcomes were evaluated. Eighty patients were included. The mean intraoperative PCI-score was 16.8, with a mean SB-PCI score of 5.9. CC0/1 was achieved in 62/80 patients. The mean follow-up period was 26.3 months. Univariate regression analysis showed that the ECOG status, the presence of severe complications, the HIPEC regimen (oxaliplatin vs. mitomycin-C), the PCI score, the SB-PCI score and the completeness of cytoreduction correlated significantly with overall survival. In multivariate analysis, the SB-PCI and CC score were identified as independent prognostic factors of survival. When the SB-PCI was stratified in three groups (0-4, 5-8 and 9-12), Kaplan-Meier curve analysis showed significant difference in survival (p<0.001). The SB-PCI correlates with overall survival in patients with peritoneal metastases secondary to colorectal cancer in this retrospective cohort. Its use should be validated in prospective patient series.
Sections du résumé
BACKGROUND
BACKGROUND
Combining cytoreductive surgery (CRS) with Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) can benefit patients with peritoneal metastasis from colorectal cancer. The present study evaluates the small bowel subset of the Peritoneal Cancer Index (Small-Bowel-PCI score (SB-PCI), min-max 0-12) as a prognostic factor in such patients.
METHODS
METHODS
We retrospectively analyzed patients that underwent CRS and HIPEC for recurrent colorectal cancer with peritoneal metastasis. Patient characteristics, procedure details, and clinical outcomes were evaluated.
RESULTS
RESULTS
Eighty patients were included. The mean intraoperative PCI-score was 16.8, with a mean SB-PCI score of 5.9. CC0/1 was achieved in 62/80 patients. The mean follow-up period was 26.3 months. Univariate regression analysis showed that the ECOG status, the presence of severe complications, the HIPEC regimen (oxaliplatin vs. mitomycin-C), the PCI score, the SB-PCI score and the completeness of cytoreduction correlated significantly with overall survival. In multivariate analysis, the SB-PCI and CC score were identified as independent prognostic factors of survival. When the SB-PCI was stratified in three groups (0-4, 5-8 and 9-12), Kaplan-Meier curve analysis showed significant difference in survival (p<0.001).
CONCLUSIONS
CONCLUSIONS
The SB-PCI correlates with overall survival in patients with peritoneal metastases secondary to colorectal cancer in this retrospective cohort. Its use should be validated in prospective patient series.
Identifiants
pubmed: 31799372
doi: 10.1515/pp-2019-0018
pii: pp-pp-2019-0018
pmc: PMC6881666
doi:
Types de publication
Journal Article
Langues
eng
Pagination
20190018Informations de copyright
© 2019 Spiliotis et al., published by De Gruyter.
Déclaration de conflit d'intérêts
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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