Risk Factors and Clinicopathological Study of Prognostic Factors in the Peritoneal Mesothelioma

2010 ◽  
Vol 76 (4) ◽  
pp. 400-405 ◽  
Author(s):  
Edward C.G. Tudor ◽  
Terence C. Chua ◽  
Winston Liauw ◽  
David L. Morris
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Disease Free Survival ◽  
Complete Cytoreduction ◽  
Peritoneal Mesothelioma ◽  
Free Survival ◽  
Disease Free

This study evaluates the clinical and treatment related prognostic indicators for survival of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma. We did an observational study of the risk factors and clinicopathological factors of 20 patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma at the St George Hospital, Sydney. Survival analysis was performed using the Kaplan-Meier method and prognostic factors were correlated with survival using the Log Rank test. There were six females. The mean age was 55 years. The overall median survival was 30 (0.5-87) months with 1- and 3-year survival of 78 per cent and 46 per cent, respectively. The overall median disease-free survival was 8 months. Factors influencing a longer disease-free survival included age ≥ 55 ( P = 0.006), not smoking ( P = 0.04), female ( P = 0.03), and epithelioid tumors ( P = 0.002). Overall survival was influenced by not consuming alcohol ( P = 0.003), complete cytoreduction ( P = 0.02), and epithelioid tumors ( P = 0.01). Risk factors identified to be prognostic for survival include the female gender, not smoking, not consuming alcohol, and an epithelioid tumor type. Treatment factor associated with an improved survival was a complete cytoreduction.

Survival according to mutations in BRAF, KRAS, or microsatellite instability (MSI-H) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastases from colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3565-3565 ◽  
Author(s):  
Stein G Larsen ◽  
Svein Dueland ◽  
M Goscinski ◽  
Sonja Steigen ◽  
Eva Hofsli ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Disease Free Survival ◽  
Peritoneal Metastases ◽  
Wild Type ◽  
Free Survival ◽  
Crs And Hipec ◽  
Disease Free

3565 Background: Patients with metastatic colorectal cancer (mCRC) and mutations in BRAF V600E (mutBRAF) or KRAS (mutKRAS) have a worse prognosis after liver or lung surgery/ablation, whereas the impact of microsatellite instability (MSI-H) has not been well studied. Few patients with mutBRAF receive liver or lung surgery (1-4%), whereas mutBRAF is present in 5-12% of mCRC trial patients and in up to 20% of the general mCRC population. The frequency and prognostic role of mutBRAF, mutKRAS and MSI has not been well studied after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases from colorectal cancer. Methods: The Norwegian Radium Hospital is the only center offering CRS and HIPEC in Norway. From 2004 to 2015 257 patients with histology proven peritoneal metastasis from colorectal cancer, appendiceal cancer excluded, was consecutively enrolled. Molecular analyses of KRAS, BRAF and MSS/MSI in mutBRAF were done. Fourteen patients were excluded due to missing tumour blocks (7), unsuccessful analysis (4) and other malignant disease (1). Results: 180 of 243 patients obtained complete cytoreductive surgery and received HIPEC for 90 minutes with Mitomycin C (45-70mg). Median survival for the 180 patients was 47 months and 5-year survival rate 40.1%. Median disease-free survival was 10 months. mutBRAF was found in 23.4% of cases, mutKRAS 35.1% and double-wild type 41.5%. mutBRAF with MSS was found in 16.4%, mutBRAF with MSI-H in 7.0%. 3-year disease free survival (DFS) and median overall survival (OS) was 38.9% and 59 months with mutBRAF with MSI-H, significantly higher compared to 24.2% and 30 months in patients with double wild type, 13.2 % and 41 months in mutKRAS and 17.9% and 22 months in mutBRAF with MSS. Conclusions: A surprisingly high frequency of mutBRAF was seen in mCRC patients after CRS and HIPEC for peritoneal metastatic disease. Patients with mutBRAF and MSI-H had a significantly better DFS and OS after CRS and HIPEC. DFS for patients with mutBRAF and MSS was numerically lower but not statistically different from patients with mutKRAS or double wild type.

scholarly journals Epididymitis following Cytoreductive Surgery with Intraperitoneal Oxaliplatin Chemotherapy: Two Case Reports

2016 ◽  
Vol 9 (1) ◽  
pp. 138-142 ◽  
Author(s):  
Luiza Damian Ribeiro Barbosa ◽  
Marcos Belotto ◽  
Renata D'Alpino Peixoto
Keyword(s):  
Postoperative Complications ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Case Reports ◽  
Disease Free Survival ◽  
Aggressive Treatment ◽  
Scrotal Pain ◽  
Free Survival ◽  
Disease Free

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy has emerged as an aggressive treatment option with intent to either cure or extend disease-free survival of selected patients with peritoneal carcinomatosis. However, postoperative complications are common. We describe the cases of 2 men who underwent CRS with hyperthermic intraperitoneal oxaliplatin and developed scrotal pain, which was consistent with noninfectious epididymitis.

scholarly journals Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from colorectal and appendiceal cancer: five-years of experience

2016 ◽  
Author(s):  
Giulia Montori ◽  
Paola Fugazzola ◽  
Marco Ceresoli ◽  
Andrea Gianatti ◽  
Vincenzo Gatti ◽  
...  
Keyword(s):  
Overall Survival ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Combined Treatment ◽  
Disease Free Survival ◽  
Appendiceal Cancer ◽  
Free Survival ◽  
Crs And Hipec ◽  
Disease Free

An increasing promising evidence support the use of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for treatment of peritoneal carcinosis from colorectal cancer (CRC) and appendiceal cancer (AC). In our institute 18 patients with CRC and 4 patients with AC undergone to CRS and HIPEC were retrospectively analyzed from 2011 to 2016. Patients and tumor characteristics were analyzed. Overall survival and disease free survival were analyzed with Kaplan-Meier curves and log-rank testing. Median disease free survival (DFS) is 20.5 and 31.4 months in CRC and AC respectively (P=0.76). Instead mean overall survival is 37.8 and 44.6 months in CRC and AC group respectively (P=0.46). Primary CRC have an improved DFS compared patients with relapse tumor (45.2 versus 19.4 months) (P=0.037). Comparing with conventional chemotherapy regimens CRS and HIPEC from CRC and AC may obtain a better disease control particularly when a complete cytoreduction is achieved. The combined treatment can have a potential curative intent.

scholarly journals Predicting Early and Late Readmissions Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

2021 ◽  
Author(s):  
Eui Whan Moon ◽  
Jolene Si Min Wong ◽  
Amanda Hui Min See ◽  
Whee Sze Ong ◽  
Chee Ann Tan ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Free Survival ◽  
Stoma Creation ◽  
Impact On Survival ◽  
Early Readmission ◽  
Worse Prognosis

Abstract Background Postoperative readmissions not only burden the healthcare system but may also affect clinical outcomes of cancer patients. Despite this, little is known about readmissions after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), or their impact on survival outcomes. Patients and Methods A single-institution retrospective cohort study of CRS-HIPEC procedures from April 2001 and September 2019 was performed. Early readmission (ERA) was defined as hospitalization within 30 days of discharge post-CRS/HIPEC, while late readmission (LRA) was defined as hospitalization between day 31 and 90 after discharge. Patient demographic, oncological, and perioperative factors were analyzed to identify predictors of readmission, and comparison of survival outcomes was performed. Results Overall, 342 patients who underwent CRS-HIPEC were included in the study. The incidence of ERA and LRA was 18.5% and 7.4%, respectively. High-grade postoperative complication was the only independent predictor of ERA (HR 3.64, 95% CI 1.47–9.02), while comorbid hypertension (HR 2.71, 95% CI 1.17–6.28) and stoma creation (HR 2.83, 95% CI 1.23–6.50) were independent predictors for LRA. Patients with readmission had significantly worse disease-free survival than patients who had no readmission (NRA) (LRA 1.1 years, ERA 1.2 years, NRA 1.8 years, p = 0.002), and patients with LRA had worse median overall survival (2.1 years) than ERA patients (3.3 years) or patients without readmission (4.4 years) (p < 0.001). Conclusions Readmission following CRS-HIPEC is associated with adverse survival outcomes. In particular, LRA may portend worse prognosis than ERA.

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