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Last modified by pmartino
Group name EquipePM
Item Type Journal Article
Title Diffuse malignant peritoneal mesothelioma: Evaluation of systemic chemotherapy with comprehensive treatment through the RENAPE Database: Multi-Institutional Retrospective Study
Creator Kepenekian et al.
Author V. Kepenekian
Author D. Elias
Author G. Passot
Author E. Mery
Author D. Delroeux
Author G. Ferron
Author J. M. Guilloit
Author M. Pocard
Author K. Abboud
Author C. Arvieux
Author C. Brigand
Author F. Marchal
Author J. M. Classe
Author G. Lorimier
Author C. De Chaisemartin
Author F. Guyon
Author P. Mariani
Author P. Ortega-Deballon
Author S. Isaac
Author C. Maurice
Author F. N. Gilly
Author O. Glehen
Author Malignancies French Network for Rare Peritoneal
Author G. Averous
Author J. M. Bereder
Author F. Bibeau
Author D. Bouzard
Author A. Chevallier
Author S. Croce
Author P. Dartigues
Author S. Durand-Fontanier
Author L. Gouthi
Author B. Heyd
Author R. Kaci
Author R. Kianmanesh
Author M. H. Laverriere
Author E. Leblanc
Author B. Lelong
Author A. Leroux
Author V. Loi
Author C. Mariette
Author S. Msika
Author D. Pezet
Author P. Peyrat
Author N. Pirro
Author J. Paineau
Author F. Poizat
Author J. Porcheron
Author F. Quenet
Author P. Rat
Author J. M. Regimbeau
Author E. Thibaudeau
Author J. J. Tuech
Author S. Valmary-Degano
Author V. Verriele
Author P. Zerbib
Author F. Zinzindohoue
Abstract PURPOSE: Diffuse malignant peritoneal mesothelioma (DMPM) is a severe disease with mainly locoregional evolution. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the reported treatment with the longest survival. The aim of this study was to evaluate the impact of perioperative systemic chemotherapy strategies on survival and postoperative outcomes in patients with DMPM treated with curative intent with CRS-HIPEC, using a multi-institutional database: the French RENAPE network. PATIENTS AND METHODS: From 1991 to 2014, 126 DMPM patients underwent CRS-HIPEC at 20 tertiary centres. The population was divided into four groups according to perioperative treatment: only neoadjuvant chemotherapy (NA), only adjuvant chemotherapy (ADJ), perioperative chemotherapy (PO) and no chemotherapy before or after CRS-HIPEC (NoC). RESULTS: All groups (NA: n = 42; ADJ: n = 16; PO: n = 16; NoC: n = 48) were comparable regarding clinicopathological data and main DMPM prognostic factors. After a median follow-up of 61 months, the 5-year overall survival (OS) was 40%, 67%, 62% and 56% in NA, ADJ, PO and NoC groups, respectively (P = 0.049). Major complications occurred for 41%, 45%, 35% and 41% of patients from NA, ADJ, PO and NoC groups, respectively (P = 0.299). In multivariate analysis, NA was independently associated with worse OS (hazard ratio, 2.30; 95% confidence interval, 1.07-4.94; P = 0.033). CONCLUSION: This retrospective study suggests that adjuvant chemotherapy may delay recurrence and improve survival and that NA may impact negatively the survival for patients with DMPM who underwent CRS-HIPEC with curative intent. Upfront CRS and HIPEC should be considered when achievable, waiting for stronger level of scientific evidence.
Publication Eur J Cancer
Volume 65
Pages 69-79
Date Jul 26 2016
DOI 10.1016/j.ejca.2016.06.002
ISSN 1879-0852 (Electronic) 0959-8049 (Linking)
Call Number IMPACT: 7.191
Extra IMPACT: 7.191
Tags clinic
Date Added 2018/07/20 - 09:15:34
Date Modified 2019/06/11 - 10:07:40
Notes and Attachments (Note)
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27472649 (Attachment)


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