BACKGROUND: Palliative chemotherapy improves survival in patients with metastasised colorectal cancer. However, there is a lack of data regarding the effectiveness of modern chemotherapy in patients with isolated peritoneal carcinomatosis (PC). PATIENTS AND METHODS: All patients with synchronous PC of colorectal origin diagnosed in the Eindhoven Cancer Registry registration area between 1995 and 2008 were included (N = 904). We assessed the use of chemotherapy and overall survival in three time periods related to the availability of different chemotherapy regimens. RESULTS: Chemotherapy use gradually increased over time. Median survival (MS) for patients with PC without other metastases diagnosed in 1995-2000 was 35 weeks [95% confidence interval (CI) 24-43] and 34 weeks (25-54) in 2005-2008. MS in patients diagnosed with PC plus other metastases was 21 weeks (15-27) in 1995-2000 and 26 weeks (18-33) in 2005-2008. In multivariable regression analysis, use of chemotherapy had a beneficial influence on survival only in 2005-2008. In the first two periods, chemotherapy treatment did not decrease the risk for death. CONCLUSION: Despite increasing usage of palliative chemotherapy and availability of new agents, population-based survival of patients with PC did not improve until very recently. Response to palliative chemotherapy in PC should be evaluated separately from haematogenous metastases.
BACKGROUND: Palliative chemotherapy improves survival in patients with metastasised colorectal cancer. However, there is a lack of data regarding the effectiveness of modern chemotherapy in patients with isolated peritoneal carcinomatosis (PC). PATIENTS AND METHODS: All patients with synchronous PC of colorectal origin diagnosed in the Eindhoven Cancer Registry registration area between 1995 and 2008 were included (N = 904). We assessed the use of chemotherapy and overall survival in three time periods related to the availability of different chemotherapy regimens. RESULTS: Chemotherapy use gradually increased over time. Median survival (MS) for patients with PC without other metastases diagnosed in 1995-2000 was 35 weeks [95% confidence interval (CI) 24-43] and 34 weeks (25-54) in 2005-2008. MS in patients diagnosed with PC plus other metastases was 21 weeks (15-27) in 1995-2000 and 26 weeks (18-33) in 2005-2008. In multivariable regression analysis, use of chemotherapy had a beneficial influence on survival only in 2005-2008. In the first two periods, chemotherapy treatment did not decrease the risk for death. CONCLUSION: Despite increasing usage of palliative chemotherapy and availability of new agents, population-based survival of patients with PC did not improve until very recently. Response to palliative chemotherapy in PC should be evaluated separately from haematogenous metastases.
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Authors: Koray Topgül; Mehmet Bilge Çetinkaya; N Çiğdem Arslan; Mustafa Kemal Gül; Murat Çan; Mahmut Fikret Gürsel; Dilek Erdem; Zafer Malazgirt Journal: Ulus Cerrahi Derg Date: 2015-09-01