Hyperthermic intraperitoneal chemotherapy + early postoperative intraperitoneal chemotherapy versus hyperthermic intraperitoneal chemotherapy alone: assessment of survival outcomes for colorectal and high-grade appendiceal peritoneal carcinomatosis - 14/08/15
, Yarrow J. McConnell, M.D. a, b, Justin D. Rivard, M.D. a, c, Walley J. Temple, M.D. a, Lloyd A. Mack, M.D. aAbstract |
Background |
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have improved survival for colorectal and high-grade appendiceal carcinomatosis. We compared the overall and recurrence-free survival (OS and RFS) of patients treated with HIPEC with mitomycin c and early postoperative intraperitoneal chemotherapy (EPIC) with fluorouracil versus HIPEC alone using oxaliplatin and simultaneous IV infusion of fluorouracil.
Methods |
Ninety-three patients with colorectal or high-grade appendiceal carcinomatosis were treated with CRS and HIPEC + EPIC or HIPEC alone. OS and RFS were analyzed using Kaplan–Meier curves and log-rank testing.
Results |
Survival did not differ between HIPEC regimens. The 3-year OS and RFS rates were 50% and 21% for HIPEC + EPIC and 46% and 6% for HIPEC alone (P = .72 and P = .89, respectively). HIPEC + EPIC patients experienced more grade III/IV complications (43.2% vs 19.6%, P = .01).
Conclusions |
There was no difference in OS and RFS between colorectal and high-grade appendiceal adenocarcinoma patients treated with CRS and HIPEC + EPIC versus HIPEC alone. However, HIPEC + EPIC patients suffered greater morbidity, making HIPEC alone the preferable regimen.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We studied survival in colorectal and high-grade appendiceal carcinomatosis. |
• | There was no survival difference between treatment with HIPEC + EPIC versus HIPEC alone. |
• | Greater morbidity is associated with the HIPEC + EPIC protocol. |
• | PCI was the only independent predictor of survival. |
• | We suggest the use of HIPEC alone after CRS in these patients. |
Keywords : Peritoneal carcinomatosis, HIPEC, Cytoreduction, Colorectal cancer, Survival
Plan
| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
|
| The authors declare no conflicts of interest. |
Vol 210 - N° 3
P. 424-430 - septembre 2015 Retour au numéro
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