Tuanhe Sun1, Kang Li1, Gang Xu1, Kun Zhu1, Qiong Wang1, Chengxue Dang1, Dawei Yuan2. 1. Department of Surgical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Yanta west street No.277, Xi'an, 710061, Shaanxi, China. 2. Department of Surgical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Yanta west street No.277, Xi'an, 710061, Shaanxi, China. dwyuan@mail.xjtu.edu.cn.
Abstract
BACKGROUND: The prognosis of patients with colorectal cancer and peritoneal metastasis (CRC-PM) after incomplete cytoreductive surgery (CRS) or palliative surgery is poor. Novel and effective therapies are urgently needed. This study aimed to assess the effects of palliative postoperative hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with CRC-PM. METHODS: This retrospective study included patients with CRC-PM at the First Affiliated Hospital of Xi'an Jiaotong University in 05/2014-05/2019. Observation indicators included overall survival (OS), ascites-free survival, peritoneal cancer index (PCI), and completeness of cytoreduction (CC). Kaplan-Meier survival curves and multivariable Cox regression models were used to determine the factors associated with OS and ascites-free survival. The ascites-specific quality of life (QoL) was measured using the Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI). RESULTS: Eighty-two patients were included, including 37 and 45 in the HIPEC and non-HIPEC groups, respectively. Mean OS was 10.3±3.7 (95% CI 9.5-11.2) months. Multivariable Cox proportional hazard regression suggested that PCI (HR=6.086, 95% CI 3.187-11.620, P < 0.0001) was independently associated with OS. The degree of ascites (HR=2.059, 95% CI 1.412-3.005, P < 0.0001), PCI (HR=6.504, 95% CI 2.844-14.875, P < 0.0001), and HIPEC (HR=0.328, 95% CI 0.191-0.562, P < 0.0001) were independently associated with ascites-free survival. In patients with survival >6 months, postoperative ascites-specific QoL was significantly improved after HIPEC compared with the non-HIPEC group (P < 0.001). Oxaliplatin-based HIPEC significantly increased the rates of neutropenia and peripheral neurotoxicity (both P < 0.05). CONCLUSION: These data indicate that postoperative oxaliplatin-based HIPEC might help increase ascites-free survival in CRC-PM patients after incomplete CRS or palliative surgery, with improved QoL after 6 months of follow-up.
BACKGROUND: The prognosis of patients with colorectal cancer and peritoneal metastasis (CRC-PM) after incomplete cytoreductive surgery (CRS) or palliative surgery is poor. Novel and effective therapies are urgently needed. This study aimed to assess the effects of palliative postoperative hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with CRC-PM. METHODS: This retrospective study included patients with CRC-PM at the First Affiliated Hospital of Xi'an Jiaotong University in 05/2014-05/2019. Observation indicators included overall survival (OS), ascites-free survival, peritoneal cancer index (PCI), and completeness of cytoreduction (CC). Kaplan-Meier survival curves and multivariable Cox regression models were used to determine the factors associated with OS and ascites-free survival. The ascites-specific quality of life (QoL) was measured using the Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI). RESULTS: Eighty-two patients were included, including 37 and 45 in the HIPEC and non-HIPEC groups, respectively. Mean OS was 10.3±3.7 (95% CI 9.5-11.2) months. Multivariable Cox proportional hazard regression suggested that PCI (HR=6.086, 95% CI 3.187-11.620, P < 0.0001) was independently associated with OS. The degree of ascites (HR=2.059, 95% CI 1.412-3.005, P < 0.0001), PCI (HR=6.504, 95% CI 2.844-14.875, P < 0.0001), and HIPEC (HR=0.328, 95% CI 0.191-0.562, P < 0.0001) were independently associated with ascites-free survival. In patients with survival >6 months, postoperative ascites-specific QoL was significantly improved after HIPEC compared with the non-HIPEC group (P < 0.001). Oxaliplatin-based HIPEC significantly increased the rates of neutropenia and peripheral neurotoxicity (both P < 0.05). CONCLUSION: These data indicate that postoperative oxaliplatin-based HIPEC might help increase ascites-free survival in CRC-PM patients after incomplete CRS or palliative surgery, with improved QoL after 6 months of follow-up.
Authors: Rebecca L Siegel; Kimberly D Miller; Ann Goding Sauer; Stacey A Fedewa; Lynn F Butterly; Joseph C Anderson; Andrea Cercek; Robert A Smith; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2020-03-05 Impact factor: 508.702
Authors: Jan Franko; Qian Shi; Jeffrey P Meyers; Timothy S Maughan; Richard A Adams; Matthew T Seymour; Leonard Saltz; Cornelis J A Punt; Miriam Koopman; Christophe Tournigand; Niall C Tebbutt; Eduardo Diaz-Rubio; John Souglakos; Alfredo Falcone; Benoist Chibaudel; Volker Heinemann; Joseph Moen; Aimery De Gramont; Daniel J Sargent; Axel Grothey Journal: Lancet Oncol Date: 2016-10-12 Impact factor: 41.316
Authors: Terence C Chua; Brendan J Moran; Paul H Sugarbaker; Edward A Levine; Olivier Glehen; François N Gilly; Dario Baratti; Marcello Deraco; Dominique Elias; Armando Sardi; Winston Liauw; Tristan D Yan; Pedro Barrios; Alberto Gómez Portilla; Ignace H J T de Hingh; Wim P Ceelen; Joerg O Pelz; Pompiliu Piso; Santiago González-Moreno; Kurt Van Der Speeten; David L Morris Journal: J Clin Oncol Date: 2012-05-21 Impact factor: 44.544
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702
Authors: Willemien J van Driel; Simone N Koole; Karolina Sikorska; Jules H Schagen van Leeuwen; Henk W R Schreuder; Ralph H M Hermans; Ignace H J T de Hingh; Jacobus van der Velden; Henriëtte J Arts; Leon F A G Massuger; Arend G J Aalbers; Victor J Verwaal; Jacobien M Kieffer; Koen K Van de Vijver; Harm van Tinteren; Neil K Aaronson; Gabe S Sonke Journal: N Engl J Med Date: 2018-01-18 Impact factor: 91.245
Authors: Francesco Santullo; Carlo Abatini; Miriam Attalla El Halabieh; Federica Ferracci; Claudio Lodoli; Lorenzo Barberis; Francesco Giovinazzo; Andrea Di Giorgio; Fabio Pacelli Journal: Front Surg Date: 2022-05-18