| Added by | pmartino |
|---|---|
| Group name | EquipePM |
| Item Type | Journal Article |
| Title | Hyperthermic intraperitoneal chemotherapy in colorectal cancer |
| Creator | Fisher et al. |
| Author | Oliver M. Fisher |
| Author | Chris Brown |
| Author | Jesus Esquivel |
| Author | Stein G. Larsen |
| Author | Winston Liauw |
| Author | Nayef A. Alzahrani |
| Author | David L. Morris |
| Author | Vahan Kepenekian |
| Author | Isabelle Sourrouille |
| Author | Jean-Jacques Tuech |
| Author | Cécilia Ceribelli |
| Author | Olivia Sgarbura |
| Author | Mohammed Alhosni |
| Author | Olivier Glehen |
| Author | Peter H. Cashin |
| Abstract | BACKGROUND: This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients. PATIENTS AND METHODS: Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received-oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed. RESULTS: Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period. CONCLUSIONS: Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported. |
| Publication | BJS open |
| Volume | 8 |
| Issue | 3 |
| Pages | zrae017 |
| Date | 2024-05-08 |
| Journal Abbr | BJS Open |
| Language | eng |
| DOI | 10.1093/bjsopen/zrae017 |
| ISSN | 2474-9842 |
| Library Catalog | PubMed |
| Extra | PMID: 38722737 PMCID: PMC11081075 |
| Tags | Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, clinic, Colorectal Neoplasms, Cytoreduction Surgical Procedures, Disease-Free Survival, Female, Humans, Male, Middle Aged, Mitomycin, Peritoneal Neoplasms, Propensity Score, Proportional Hazards Models, Retrospective Studies, Treatment Outcome |
| Date Added | 2024/08/02 - 09:52:54 |
| Date Modified | 2024/08/02 - 10:00:27 |
| Notes and Attachments | Full Text (Attachment) PubMed entry (Attachment) |
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