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Cytoreductive Surgery and Intraperitoneal Chemotherapy for Colorectal Peritoneal Carcinomatosis Prognosis and Treatment of Recurrences in a Cohort Study

Cashin, Peter H, 1984- (författare)
Uppsala universitet, Kolorektalkirurgi, Peritoneal Carcinomatos Forskargrupp
Graf, Wilhelm, (författare)
Uppsala universitet, Kolorektalkirurgi
Nygren, Peter, (författare)
Uppsala universitet, Enheten för onkologi
visa fler...
Mahteme, Haile, (författare)
Uppsala universitet, Kolorektalkirurgi
visa färre...
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för kirurgiska vetenskaper. Kolorektalkirurgi. (creator_code:org_t)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för radiologi, onkologi och strålningsvetenskap. Enheten för onkologi. (creator_code:org_t)
2012
Engelska.
Ingår i: European Journal of Surgical Oncology. - 0748-7983 .- 1532-2157. ; 38:6, s. 509-515
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  • BackgroundCytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) treatment of colorectal peritoneal carcinomatosis (PC) is gaining acceptance, but controversy remains. The primary aims were to analyze the outcome and prognostic variables of colorectal PC patients treated with CRS and IPC, and to report on the outcome of additional surgical treatments of subsequent recurrences.MethodsPatients referred for treatment of colorectal PC between 1996 and 2010 were included in a cohort. The following data was collected: clinicopathological parameters, survival, recurrences, perioperative chemotherapy and type of IPC (hyperthermic intraperitoneal chemotherapy, HIPEC; or sequential postoperative intraperitoneal chemotherapy, SPIC). Multivariable analyses were conducted on potential prognostic factors for overall survival (OS).ResultsIn the 151-patient cohort, the median OS was 34months (range: 2-77) for CRS and HIPEC with five-year survival predicted at 40% (five-year disease-free survival 32%). For CRS and SPIC, the OS was 25months (range: 2-188) with five-year survival at 18%.  Open-and-close patients survived 6months (range: 0-14) with no five-year survival (HIPEC vs. SPIC p=0.047, SPIC vs. open-and-close p<0.001). Adjuvant systemic chemotherapy was a noteworthy independent prognostic factor in the multivariable analysis. OS for patients undergoing additional surgical treatment of recurrences was 25months vs. 10months with best supportive care or palliative chemotherapy (p=0.01).ConclusionSubstantial long-term survival is possible in patients with colorectal PC. HIPEC was associated with better OS than SPIC and adjuvant systemic chemotherapy may improve the outcome in patients. Good OS is achievable in selected patients undergoing additional surgical treatment of isolated liver or peritoneal recurrences after prior complete CRS.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

HIPEC
Intraperitoneal chemotherapy
Colorectal cancer
Peritoneal carcinomatosis
Cytoreductive surgery
Recurrences
Kirurgi
Surgery

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Cashin, Peter H, ...
Graf, Wilhelm
Nygren, Peter
Mahteme, Haile
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