| Added by | pmartino |
|---|---|
| Group name | EquipePM |
| Item Type | Journal Article |
| Title | Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Metastases (CYTO-CHIP study): A Propensity Score Analysis |
| Creator | Bonnot et al. |
| Author | Pierre-Emmanuel Bonnot |
| Author | Guillaume Piessen |
| Author | Vahan Kepenekian |
| Author | Evelyne Decullier |
| Author | Marc Pocard |
| Author | Bernard Meunier |
| Author | Jean-Marc Bereder |
| Author | Karine Abboud |
| Author | Frédéric Marchal |
| Author | Diane Goere |
| Author | Simon Msika |
| Author | Catherine Arvieux |
| Author | Nicolas Pirro |
| Author | Romuald Wernert |
| Author | Patrick Rat |
| Author | Johan Gagnière |
| Author | Jeremie H. Lefevre |
| Author | Thomas Courvoisier |
| Author | Reza Kianmanesh |
| Author | Delphine Vaudoyer |
| Author | Michel Rivoire |
| Author | Pierre Meeus |
| Author | Guillaume Passot |
| Author | Olivier Glehen |
| Abstract | PURPOSE: Gastric cancer (GC) with peritoneal metastases (PMs) is a poor prognostic evolution. Cytoreductive surgery (CRS) yields promising results, but the impact of hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. Here we aimed to compare outcomes between CRS-HIPEC versus CRS alone (CRSa) among patients with PMs from GC. PATIENTS AND METHODS: From prospective databases, we identified 277 patients with PMs from GC who were treated with complete CRS with curative intent (no residual nodules > 2.5 mm) at 19 French centers from 1989 to 2014. Of these patients, 180 underwent CRS-HIPEC and 97 CRSa. Tumor burden was assessed using the peritoneal cancer index. A Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW) based on propensity score was used to assess the effect of HIPEC and account for confounding factors. RESULTS: After IPTW adjustment, the groups were similar, except that median peritoneal cancer index remained higher in the CRS-HIPEC group (6 v 2; P = .003). CRS-HIPEC improved overall survival (OS) in both crude and IPTW models. Upon IPTW analysis, in CRS-HIPEC and CRSa groups, median OS was 18.8 versus 12.1 months, 3- and 5-year OS rates were 26.21% and 19.87% versus 10.82% and 6.43% (adjusted hazard ratio, 0.60; 95% CI, 0.42 to 0.86; P = .005), and 3- and 5-year recurrence-free survival rates were 20.40% and 17.05% versus 5.87% and 3.76% (P = .001), respectively; the groups did not differ regarding 90-day mortality (7.4% v 10.1%, respectively; P = .820) or major complication rate (53.7% v 55.3%, respectively; P = .496). CONCLUSION: Compared with CRSa, CRS-HIPEC improved OS and recurrence-free survival, without additional morbidity or mortality. When complete CRS is possible, CRS-HIPEC may be considered a valuable therapy for strictly selected patients with limited PMs from GC. |
| Publication | Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology |
| Pages | JCO1801688 |
| Date | May 14, 2019 |
| Journal Abbr | J. Clin. Oncol. |
| Language | eng |
| DOI | 10.1200/JCO.18.01688 |
| ISSN | 1527-7755 |
| Short Title | Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Metastases (CYTO-CHIP study) |
| Library Catalog | PubMed |
| Call Number | IMPACT: 26.36 |
| Extra | PMID: 31084544 IMPACT: 26.36 |
| Tags | clinic, Cytoreduction Surgical Procedures, Female, Humans, Hyperthermia, Induced, Male, Middle Aged, Neoplasm Metastasis, PBVOL, Peritoneal Neoplasms, Prognosis, Prospective Studies, Stomach Neoplasms |
| Date Added | 2019/05/22 - 08:48:06 |
| Date Modified | 2021/03/05 - 10:43:05 |
| Notes and Attachments | PubMed entry (Attachment) PubMed entry (Attachment) |
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