A total neoadjuvant chemotherapy approach is associated with improved recurrence-free survival in patients with colorectal peritoneal metastases undergoing cytoreductive surgery and HIPEC.
Humans
Hyperthermic Intraperitoneal Chemotherapy
Colorectal Neoplasms
/ pathology
Neoadjuvant Therapy
Peritoneal Neoplasms
/ secondary
Cytoreduction Surgical Procedures
Retrospective Studies
Chemotherapy, Cancer, Regional Perfusion
Hyperthermia, Induced
Survival Rate
Combined Modality Therapy
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
CRS-HIPEC
colorectal cancer
outcomes
peritoneal carcinomatosis
systemic chemotherapy
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
revised:
20
09
2022
received:
11
06
2022
accepted:
24
10
2022
pubmed:
10
11
2022
medline:
1
2
2023
entrez:
9
11
2022
Statut:
ppublish
Résumé
The primary aim of this study is to evaluate the oncologic outcomes of two popular systemic chemotherapy approaches in patients with colorectal peritoneal metastases (CPM) undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). We performed a dual-center retrospective review of consecutive patients who underwent CRS-HIPEC for CPM due to high or intermediate-grade colorectal cancer. Patients in the total neoadjuvant therapy (TNT) group received 6 months of preoperative chemotherapy. Patients in the "sandwich" (SAND) chemotherapy group received 3 months of preoperative chemotherapy with a maximum of 3 months of postoperative chemotherapy. A total of 34 (43%) patients were included in the TNT group and 45 (57%) patients in the SAND group. The median overall survival (OS) in the TNT and SAND groups were 77 and 61 months, respectively (p = 0.8). Patients in the TNT group had significantly longer recurrence-free survival (RFS) than the SAND group (29 vs. 12 months, p = 0.02). In a multivariable analysis, the TNT approach was independently associated with improved RFS. In this retrospective study, a TNT approach was associated with improved RFS, but not OS when compared with a SAND approach. Further prospective studies are needed to examine these systemic chemotherapeutic approaches in patients with CPM undergoing CRS-HIPEC.
Sections du résumé
BACKGROUND
BACKGROUND
The primary aim of this study is to evaluate the oncologic outcomes of two popular systemic chemotherapy approaches in patients with colorectal peritoneal metastases (CPM) undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
METHODS
METHODS
We performed a dual-center retrospective review of consecutive patients who underwent CRS-HIPEC for CPM due to high or intermediate-grade colorectal cancer. Patients in the total neoadjuvant therapy (TNT) group received 6 months of preoperative chemotherapy. Patients in the "sandwich" (SAND) chemotherapy group received 3 months of preoperative chemotherapy with a maximum of 3 months of postoperative chemotherapy.
RESULTS
RESULTS
A total of 34 (43%) patients were included in the TNT group and 45 (57%) patients in the SAND group. The median overall survival (OS) in the TNT and SAND groups were 77 and 61 months, respectively (p = 0.8). Patients in the TNT group had significantly longer recurrence-free survival (RFS) than the SAND group (29 vs. 12 months, p = 0.02). In a multivariable analysis, the TNT approach was independently associated with improved RFS.
CONCLUSION
CONCLUSIONS
In this retrospective study, a TNT approach was associated with improved RFS, but not OS when compared with a SAND approach. Further prospective studies are needed to examine these systemic chemotherapeutic approaches in patients with CPM undergoing CRS-HIPEC.
Identifiants
pubmed: 36350108
doi: 10.1002/jso.27136
pmc: PMC9892314
mid: NIHMS1845856
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
442-449Subventions
Organisme : NCI NIH HHS
ID : T32 CA106183
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR004419
Pays : United States
Organisme : NCI NIH HHS
ID : T32CA106183
Pays : United States
Informations de copyright
© 2022 Wiley Periodicals LLC.
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