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Cytoreductive Surgery Combined With Perioperative Intraperitoneal Chemotherapy for the Management of Peritoneal Carcinomatosis From Colorectal Cancer: A Multi-Institutional Study
Abstract
Purpose: The three principal studies dedicated to the natural history of peritoneal carcinomatosis (PC) from colorectal cancer consistently showed median survival ranging between 6 and 8 months. New approaches combining cytoreductive surgery and perioperative intraperitoneal chemotherapy suggest improved survival. Patients and Methods: A retrospective multicenter study was performed to evaluate the international experience with this combined treatment and to identify the principal prognostic indicators. All patients had cytoreductive surgery and perioperative intraperitoneal chemotherapy (intraperitoneal chemohyperthermia and/or immediate postoperative intraperitoneal chemotherapy). PC from appendiceal origin was excluded. Results: The study included 506 patients from 28 institutions operated between May 1987 and December 2002. Their median age was 51 years. The median follow-up was 53 months. The morbidity and mortality rates were 22.9% and 4%, respectively. The overall median survival was 19.2 months. Patients in whom cytoreductive surgery was complete had a median survival of 32.4 months, compared with 8.4 months for patients in whom complete cytoreductive surgery was not possible (P < .001). Positive independent prognostic indicators by multivariate analysis were complete cytoreduction, treatment by a second procedure, limited extent of PC, age less than 65 years, and use of adjuvant chemotherapy. The use of neoadjuvant chemotherapy, lymph node involvement, presence of liver metastasis, and poor histologic differentiation were negative independent prognostic indicators. Conclusion: The therapeutic approach combining cytoreductive surgery with perioperative intraperitoneal chemotherapy achieved long-term survival in a selected group of patients with PC from colorectal origin with acceptable morbidity and mortality. The complete cytoreductive surgery was the most important prognostic indicator.
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Cited by
Franko, J., Shi, Q., Goldman, C. D., Pockaj, B. A., Nelson, G. D., Goldberg, R. M., Pitot, H. C., Grothey, A., Alberts, S. R., & Sargent, D. J. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.37.1039 · Cited by 587
Coccolini, F. (2013) · World Journal of Gastroenterology · doi:10.3748/wjg.v19.i41.6979 · Cited by 325
Survival improvement for patients with metastatic colorectal cancer over twenty years
Zeineddine, F. A., Zeineddine, M. A., Yousef, A., Gu, Y., Chowdhury, S., Dasari, A., Huey, R. W., Johnson, B., Kee, B., Lee, M. S., et al. (2023) · npj Precision Oncology · doi:10.1038/s41698-023-00353-4 · Cited by 192
Mc Larney, B. E., Sonay, A. Y., Apfelbaum, E., Mostafa, N., Monette, S., Goerzen, D., Aguirre, N., Exner, R. M., Habjan, C., Isaac, E., et al. (2024) · Nature Biomedical Engineering · doi:10.1038/s41551-024-01248-w · Cited by 28
Cohen, M. S., Al-kasspooles, M. F., Williamson, S. K., Henry, D., Broward, M., & Roby, K. F. (2010) · Annals of Surgical Oncology · doi:10.1245/s10434-009-0669-0 · Cited by 17
Metadata
- Authors
- Glehen, O., Kwiatkowski, F., Sugarbaker, P. H., Elias, D., Levine, E. A., De Simone, M., Barone, R., Yonemura, Y., Cavaliere, F., Quenet, F., Gutman, M., Tentes, A. A. K., Lorimier, G., Bernard, J. L., Bereder, J. M., Porcheron, J., Gomez-Portilla, A., Shen, P., Deraco, M., & Rat, P.
- Venue
- Journal of Clinical Oncology
- Published
- 2004-08-15
- Volume
- 22
- Issue
- 16
- Pages
- 3284-3292
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2127015783
- Cited by
- 1,184
- References
- 4
- FWCI
- 37.86
- Type
- journal article
- Language
- en
- Open access
- closed
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- Glehen, O., Kwiatkowski, F., Sugarbaker, P. H., Elias, D., Levine, E. A., De Simone, M., Barone, R., Yonemura, Y., Cavaliere, F., Quenet, F., Gutman, M., Tentes, A. A. K., Lorimier, G., Bernard, J. L., Bereder, J. M., Porcheron, J., Gomez-Portilla, A., Shen, P., Deraco, M., & Rat, P. (2004). Cytoreductive Surgery Combined With Perioperative Intraperitoneal Chemotherapy for the Management of Peritoneal Carcinomatosis From Colorectal Cancer: A Multi-Institutional Study. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2004.10.012
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
