Cytoreductive surgery and HIPEC improve survival compared to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: A multi-institutional cohort from PSOGI and BIG RENAPE groups

2018 ◽  
Vol 44 (9) ◽  
pp. 1378-1383 ◽  
Author(s):  
I. Amblard ◽  
F. Mercier ◽  
D.L. Bartlett ◽  
S.A. Ahrendt ◽  
K.W. Lee ◽  
...  
Keyword(s):  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Palliative Chemotherapy ◽  
Biliary Carcinoma

Effect of cytoreductive surgery and HIPEC on survival in comparison to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: A multi-institutional cohort from PSOGI and BIG RENAPE groups.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 418-418
Author(s):  
Frederic Mercier ◽  
Iris Amblard ◽  
David L. Bartlett ◽  
Edward Allen Levine ◽  
Dario Baratti ◽  
...  
Keyword(s):  
Overall Survival ◽  
Peritoneal Metastasis ◽  
Palliative Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Rank Test ◽  
Medical Group ◽  
Biliary Carcinoma ◽  
Peritoneal Cancer ◽  
The Impact ◽  
Surgical Group

418 Background: Peritoneal metastasis from biliary carcinoma (PMC) is associated with poor prognosis when treated with chemotherapy. The objective was to evaluate the impact on survival of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and compare with conventional palliative chemotherapy for patients with PMC. Methods: A prospective multicenter international database was retrospectively searched to identify all patients with PMC treated with a potentially curative CRS/HIPEC (CRS/HIPEC group). The overall survival (OS) was compared to patients with PMC treated with palliative chemotherapy (systemic chemotherapy group). Survival was analyzed using Kaplan-Meier method and compared with Log-Rank test. Results: Between 1995 and 2015, 34 patients were included in the surgical group, and compared to 21 in the medical group. In the surgical group, median peritoneal cancer index was 9 (range 3-26), macroscopically complete resection was obtained for 25 patients (73%). There was more gallbladder localization in the surgical group compared to the medical group (35% vs. 18%, p= 0.001). Median OS was 21.4 and 9.3 months for surgical and medical group, respectively (p =0.007). Three-year overall survival was 30% and 10% for surgical and medical group, respectively. Conclusions: Treatment with CRS and HIPEC for cholangiocarcinoma with peritoneal metastasis is feasible and may provide survival benefit when compared to palliative chemotherapy.

scholarly journals Cytoreductive Surgery Combined with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Colorectal Cancer

2020 ◽  
Vol 33 (06) ◽  
pp. 372-376
Author(s):  
Hideaki Yano
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Systemic Disease ◽  
Good Reason ◽  
Standard Of Care ◽  
Peritoneal Cancer

AbstractPeritoneal metastasis from colorectal cancer (PM-CRC) is used to be considered a systemic and fatal condition; however, it has been growingly accepted that PM-CRC can still be local disease rather than systemic disease as analogous to liver or lung metastasis.Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is now considered an optimal treatment for PM-CRC with accumulating evidence. There is a good reason that CRS + HIPEC, widely accepted as a standard of care for pseudomyxoma peritonei (PMP), could be a viable option for PM-CRC given a similarity between PM-CRC and PMP.Recent years have also seen that modern systemic chemotherapy with or without molecular targeted agents can be effective for PM-CRC. It is possible that neoadjuvant or adjuvant chemotherapy combined with CRS + HIPEC could further improve outcomes.Patient selection, utilizing modern images and increasingly laparoscopy, is crucial. Particularly, diagnostic laparoscopy is likely to play a significant role in predicting the likelihood of achieving complete cytoreduction and assessing the peritoneal cancer index score.

Quality standards for cytoreductive surgery and HIPEC of colorectal peritoneal metastasis.

2021 ◽  
Vol 47 (2) ◽  
pp. e48
Author(s):  
Alfonso García-Fadrique ◽  
Sabater Luis ◽  
Escrig Sos Javier ◽  
Estevan Estevan Rafael
Keyword(s):  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Quality Standards

Effect of postoperative morbidity on survival after cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis in a series of 700 cases.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3565-3565
Author(s):  
Clarisse Eveno ◽  
Roberto Schiavone ◽  
Marc Pocard ◽  
Thierry Andre ◽  
Marie-Josee Caballero ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Disease Free Survival ◽  
Hemorrhagic Complication ◽  
Major Morbidity ◽  
Entire Cohort ◽  
Asa Score ◽  
Heated Intraperitoneal Chemotherapy

3565 Background: Major morbidity (MM) after cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) is associated with worsening of disabilities and length of the hospital stay. This study aimed to identify MM prognostic factors and to measure its impact on oncological outcomes. Methods: A post-hoc analysis of a prospective cohort of 734 patients with peritoneal metastasis (PM) from 2006 to 2015 was undertaken. Five hundred and two patients who had complete CRS and HIPEC for PM were included. Results: Major morbidity was identified in 31% (156/502) of CRS/HIPEC procedures, including 67 hemorrhagic complication (13.3%), 87 anastomotic leaks (17.4%), 121 reoperation (24.1%), and 65 pulmonary complication (12.9%). The multivariate predictors of MM were American Society of Anesthesiologists (ASA) score (ASA 3 vs. 1-2, 0R 95%CI: 3.58 [1.54 – 8.34]), origin of PM colorectal adenocarcinoma vs. other, OR 95%CI: 1.62 [1.06 – 2.48]), type of HIPEC drug (oxaliplatin vs. other, OR 95%CI: 2.85 [1.28 – 6.32]), number of anastomosis (no vs. at least 1, HR 95%CI: 1.85 [1.19 – 2.88]), blood transfusion (OR 95%CI: 1.84 [1.05 – 3.23]) and length of surgery longer than the median value (OR 95%CI: 1.88 [1.22 – 2.91]). The in-hospital mortality rate for the entire cohort was 1.7% (9/502). Rate of adjuvant chemotherapy after CRS/HIPEC was comparable between the two groups (70.3% vs. 72.4%, p = 0.64). The median duration of follow-up was 18 months. The MM group had worst OS and DFS comparing non-MM (Hazard ratio and 95% confidence interval at 3.48 [1.90 ; 6.35] and 1.91 [1.43 ; 2.57], respectively). Conclusions: Major morbidity after CRS/HIPEC for peritoneal metastasis is a source of significant reoperation and longer hospital and intensive care unit stay; with a decrease in overall survival and disease free survival even after complete CRS. Preoperative ASA score, number of anastomoses, colorectal origin of PM, HIPEC with oxaliplatin, blood transfusion and length of surgery are independent predictors of MM for CRS/HIPEC patients.

Retrospective analysis of the effects of systemic chemotherapy to the ovarian metastases from colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 731-731 ◽  
Author(s):  
Katsutoshi Sekine ◽  
Tetsuya Hamaguchi ◽  
Hirokazu Shoji ◽  
Shoko Nakamura ◽  
Takahiro Miyamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Cytoreductive Surgery ◽  
Systemic Chemotherapy ◽  
Palliative Chemotherapy ◽  
Objective Response ◽  
First Line ◽  
Ovarian Metastases ◽  
Third Line ◽  
Metastatic Sites

731 Background: Ovarian metastases from colorectal cancers are relatively rare. Since most ovarian metastases are also associated with other metastatic sites, the prognosis is reported to be poor. It is not fully understood whether the response to systemic chemotherapy of ovarian metastases differs from that to other metastatic sites. Methods: We retrospectively reviewed the clinical data of patients with ovarian metastases from colorectal cancer treated at our hospital between January 2006 and December 2015. Results: Among the 635 female patients with relapsed or metastatic colorectal cancer, 57 (9.0%) had ovarian metastases before the first-line treatment; 37 patients received palliative chemotherapy, and 20 patients were initially treated by surgical resection. In addition, 38 cases of ovarian metastases developed after the initiation of first-line chemotherapy. Overall, 95 patients (15.0%) with ovarian metastases were treated during this period. The objective response rate for systemic chemotherapy of ovarian metastases was lower than that for other metastatic sites (22.9 % vs 60.9 % for first-line, 3.4 % vs 13.6 % for second-line, 11.1 % vs 26.6 % for third-line, and 0% vs 18.2 % for fourth-line, respectively). After the initiation of chemotherapy, surgical resection of ovarian metastases was positively associated with a longer overall survival (26.8 months for cytoreductive surgery and 17.0 months for only systemic chemotherapy, p < 0.001), especially when the other metastatic sites had not progressed after chemotherapy. Conclusions: Ovarian metastases are less responsive to systemic chemotherapy compared to the extra-ovarian metastases. Our data also suggest that multi-disciplinary treatment strategy including systemic chemotherapy and cytoreductive surgery might improve the prognosis of ovarian metastases.

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