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Added by pmartino
Group name EquipePM
Item Type Journal Article
Title Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
Creator Cashin et al.
Author Peter H. Cashin
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 Beranger Doussot
Author Olivia Sgarbura
Author Olivier Glehen
Author Oliver M. Fisher
Abstract BACKGROUND: There is a paucity of studies evaluating perioperative systemic chemotherapy in conjunction with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer peritoneal metastases (CRCPM). The aim was to evaluate neoadjuvant and/or adjuvant systemic therapy in CRCPM. METHODS: Patients with CRCPM from 39 treatment centres globally from January 1, 1991, to December 31, 2018, who underwent CRS+HIPEC were identified and stratified according to neoadjuvant/adjuvant use. Crude data analysis, propensity score matching (PSM) and Cox-proportional hazard modelling was performed. FINDINGS: Of 2093 patients, 1613 were included in neoadjuvant crude evaluation with 708 in the PSM cohort (354 patients/arm). In the adjuvant evaluation, 1176 patients were included in the crude cohort with 778 in the PSM cohort (389 patients/arm). The median overall survival (OS) in the PSM cohort receiving no neoadjuvant vs neoadjuvant therapy was 37.0 months (95% CI: 32.6-42.7) vs 34.7 months (95% CI: 31.2-38.8, HR 1.08 95% CI: 0.88-1.32, p = 0.46). The median OS in the PSM cohort receiving no adjuvant therapy vs adjuvant therapy was 37.0 months (95% CI: 32.9-41.8) vs 45.7 months (95% CI: 38.8-56.2, HR 0.79 95% CI: 0.64-0.97, p = 0.022). Recurrence-free survival did not differ in the neoadjuvant evaluation but differed in the adjuvant evaluation - HR 1.04 (95% CI: 0.87-1.25, p = 0.66) and 0.83 (95% CI: 0.70-0.98, p = 0.03), respectively. Multivariable Cox-proportional hazard modelling in the crude cohorts showed hazard ratio 1.08 (95% CI: 0.92-1.26, p = 0.37) for administering neoadjuvant therapy and 0.86 (95% CI: 0.72-1.03, p = 0.095) for administering adjuvant therapy. INTERPRETATION: Neoadjuvant therapy did not confer a benefit to patients undergoing CRS+HIPEC for CRCPM, whereas adjuvant therapy was associated with a benefit in this retrospective setting. FUNDING: None.
Publication EClinicalMedicine
Volume 55
Pages 101746
Date 2023-01
Journal Abbr EClinicalMedicine
Language eng
DOI 10.1016/j.eclinm.2022.101746
ISSN 2589-5370
Short Title Perioperative chemotherapy in colorectal cancer with peritoneal metastases
Library Catalog PubMed
Extra PMID: 36457647 PMCID: PMC9706515
Tags Adjuvant chemotherapy, clinic, Cytoreductive surgery, Neoadjuvant chemotherapy, Peritoneal metastases
Date Added 2023/02/25 - 11:49:36
Date Modified 2024/03/01 - 09:41:53
Notes and Attachments Full Text (Attachment)
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