Long-Term Outcomes following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Number of Patients, n (%) |
---|---|
Age, mean (SD), y | 54.5 (12.4) |
Gender Male Female | 63 (50.4) 62 (49.6) |
Index surgery | 113 (90.4) |
Origin of cancer Colon Sigmoid Ascending colon Cecum Transverse colon Descending colon Rectum | 108 (86.4) 42 (33.6) 33 (26.4) 20 (16.0) 10 (8.0) 3 (2.4) 17 (13.6) |
Index nodal status Positive | 82 (65.6) |
Pathology Mucinous adenocarcinoma BRAF mutated | 35 (28.0) 10 (8.0) |
Differentiation Well differentiated Moderately differentiated Poorly differentiated Signet Ring | 26 (21.9) 63 (52.9) 22 (18.5) 8 (6.7) |
Peritoneal Metastasis | |
Synchronous | 65 (52.0) |
Extraperitoneal disease 1 | 22 (17.6) |
Preoperative systemic therapy | 101 (80.8) |
Response to systemic therapy Disease response Stable disease Disease progression | 47 (46.5) 40 (39.6) 14 (13.9) |
Surgical Details | |
ASA 2, median (range) | 2 (1–3) |
Complete cytoreduction (CC) CC-0 CC-1 CC-2 | 121 (96.8) 2 (1.6) 2 (1.6) |
PCI 3, mean (range) | 11 (0–39) |
EBL 4, mean (range), mL | 756 (50–3000) |
Surgery duration, mean (SD), min | 394.5 (97.2) |
Surgical resection Bowel resection Diaphragm stripping Index cancer resection | 113 (90.4) 50 (40.0) 24 (19.2) |
HIPEC 5 regimen Mitomycin C Oxaliplatin | 20 (16.0) 105 (84.0) |
EPIC 6 | 8 (6.4) |
Postoperative Details | |
Length of stay, mean (range), d | 20.9 (7–84) |
All complications Clavien–-Dindo III Clavien–Dindo IV Reoperation ICU 7 stay | 75 (60.0) 19 (25.3) 3 (4.0) 11 (8.8) 21 (16.8) |
Survival | Variable | Hazard Ratio | 95% Confidence Interval | p-Value |
---|---|---|---|---|
OS DFS | Age | 0.99 0.99 | 0.98–1.01 0.98–1.02 | 0.492 0.814 |
OS DFS | Index cancer (ref. colon) | 1.18 1.25 | 0.67–2.08 0.71–2.20 | 0.566 0.446 |
OS DFS | Index cancer node-positive | 1.06 1.17 | 0.69–1.62 0.77–1.78 | 0.801 0.459 |
OS DFS | Synchronous peritoneal metastasis | 0.88 0.95 | 0.60–1.32 0.64–1.40 | 0.544 0.787 |
OS DFS | Synchronous extraperitoneal metastasis | 1.13 1.01 | 1.08–1.90 0.593–1.69 | 0.039 0.998 |
OS DFS | Pre-HIPEC systemic therapy | 1.49 1.53 | 1.19–2.49 0.91–2.58 | 0.032 0.110 |
OS DFS | Progression on pre-HIPEC systemic therapy | 1.07 1.57 | 0.59–1.94 1.38–2.81 | 0.824 0.043 |
OS DFS | PCI ≥ 20 | 1.85 1.34 | 1.12–3.06 0.74–2.43 | 0.017 0.332 |
OS DFS | Post-HIPEC systemic therapy | 1.21 1.38 | 0.80–1.81 0.89–2.15 | 0.365 0.154 |
Characteristics | Alive at 5 Years (LTS) 24.8% (n = 31) | Mortality < 5 Years (Non-LTS) 75.2% (n = 94) | p-Value |
---|---|---|---|
Age (years) | 54.28 (±12.82) | 55.18 (±11.04) | 0.726 |
Sex n (%) Female Male | 15 (48.4) 16 (51.6) | 47 (50.0) 47 (50.0) | 0.876 |
Primary tumor location n (%) Colon Rectum | 27 (87.1) 4 (12.9) | 81 (86.2) 13 (13.8) | 0.896 |
Synchronous peritoneal disease n (%) | 14 (45.2) | 51 (54.3) | 0.379 |
Synchronous extra-peritoneal disease n (%) | 26 (83.9) | 77 (81.9) | 0.804 |
Histology n (%) Adenocarcinoma Well differentiated Moderately differentiated Poorly differentiated Signet ring | 5 (16.1) 18 (58.1) 4 (13.0) 1 (3.2) | 21 (22.3) 45 (47.9) 18 (19.1) 7 (7.4) | 0.563 |
Preoperative systemic therapy n (%) | 23 (74.2) | 78 (83.0) | 0.070 |
Response to systemic therapy n (%) Improvement of stable disease Disease progression | 19 (61.3) 4 (12.9) | 68 (72.3) 10 (10.6) | 0.577 |
Index cancer disease-free interval (months) (SD) | 12.9 (16.1) | 10.8 (15.1) | 0.507 |
Characteristics | Alive at 5 Years (LTS) 24.8% (n = 31) | Mortality < 5 Years (Non-LTS) 75.2% (n = 94) | p-Value |
---|---|---|---|
Type of chemotherapy n (%) Oxaliplatin Mitomycin C | 28 (90.3) 3 (9.7) | 77 (81.9) 17 (18.1) | 0.268 |
Intraperitoneal chemotherapy n (%) HIPEC HIPEC + EPIC | 28 (90.3) 3 (9.7) | 89 (94.7) 5 (5.3) | 0.390 |
Median PCI | 9 | 13 | 0.044 |
PCI group n (%) Low (<20) High (≥20) | 27 (87.1) 4 (12.9) | 78 (83.0) 16 (17.0) | 0.588 |
CC-0 n (%) | 31 (100.0) | 90 (95.7) | 0.243 |
OR duration (mins) (SD) | 355 (81.2) | 407 (98.9) | 0.010 |
Complications n (%) Grade 1 and 2 Grade 3 and 4 | 14 (45.2) 8 (25.8) 6 (19.4) | 61 (64.9) 45 (47.9) 16 (17.0) | 0.041 |
Postoperative systemic therapy n (%) | 9 (30.0) | 42 (44.7) | 0.155 |
Recurrence post CRS–HIPEC n (%) | 13 (41.9) | 87 (92.6) | <0.001 |
Recurrence disease-free interval (months) (SD) | 74.9 (52.2) | 14.2 (10.4) | <0.001 |
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Taqi, K.; Lee, J.; Hurton, S.; Stockley, C.; Mack, L.; Rivard, J.; Temple, W.; Bouchard-Fortier, A. Long-Term Outcomes following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin. Curr. Oncol. 2024, 31, 3657-3668. https://doi.org/10.3390/curroncol31070269
Taqi K, Lee J, Hurton S, Stockley C, Mack L, Rivard J, Temple W, Bouchard-Fortier A. Long-Term Outcomes following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin. Current Oncology. 2024; 31(7):3657-3668. https://doi.org/10.3390/curroncol31070269
Chicago/Turabian StyleTaqi, Kadhim, Jay Lee, Scott Hurton, Cecily Stockley, Lloyd Mack, Justin Rivard, Walley Temple, and Antoine Bouchard-Fortier. 2024. "Long-Term Outcomes following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin" Current Oncology 31, no. 7: 3657-3668. https://doi.org/10.3390/curroncol31070269
APA StyleTaqi, K., Lee, J., Hurton, S., Stockley, C., Mack, L., Rivard, J., Temple, W., & Bouchard-Fortier, A. (2024). Long-Term Outcomes following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin. Current Oncology, 31(7), 3657-3668. https://doi.org/10.3390/curroncol31070269