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Cytoreductive surgery and intraperitoneal chemotherapy versus systemic chemotherapy for colorectal peritoneal metastases : A randomised trial

Cashin, Peter H., (författare)
Uppsala universitet, Kolorektalkirurgi
Mahteme, Haile, (författare)
Uppsala universitet, Institutionen för kirurgiska vetenskaper, Uppsala Canc Clin, Uppsala, Sweden.
Spang, N., (författare)
Uppsala universitet, Institutionen för kirurgiska vetenskaper
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Syk, I., (författare)
Skane Univ Hosp, Dept Surg, S-21428 Malmo, Sweden.
Frodin, J. E., (författare)
Karolinska Inst, Dept Pathol & Oncol, S-17176 Stockholm, Sweden.
Torkzad, Michael, (författare)
Uppsala universitet, Radiologi
Glimelius, Bengt, (författare)
Uppsala universitet, Experimentell och klinisk onkologi, Karolinska Inst, Dept Pathol & Oncol, S-17176 Stockholm, Sweden.
Graf, Wilhelm, (författare)
Uppsala universitet, Kolorektalkirurgi
visa färre...
2016
Engelska.
Ingår i: European Journal of Cancer. - 0959-8049 .- 1879-0852. ; 53, s. 155-162
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • <p>Background: First-line treatment of isolated resectable colorectal peritoneal metastases remains unclear. This study (the Swedish peritoneal study) compares cytoreductive surgery and intraperitoneal chemotherapy (surgery arm) with systemic chemotherapy (chemotherapy arm). Methods: Patients deemed resectable preoperatively were randomised to surgery and intraperitoneal 5-fluorouracil 550 mg/m(2) /d for 6 d with repeated courses every month or to systemic oxaliplatin and 5-fluorouracil regimen every second week. Both treatments continued for 6 months. Primary end-point was overall survival (OS) and secondary end-points were progression-free survival (PFS), and morbidity. Results: The study terminated prematurely when 48 eligible patients (24/arm) were included due to recruitment difficulties. Two-year OS was 54% in the surgery arm and 38% in the chemotherapy arm (p = 0.04). After 5 years, 8 versus 1 patient were alive, respectively (p = 0.02). Median OS was 25 months versus 18 months, respectively, hazard ratio 0.51 (95% confidence interval: 0.27-0.96, p = 0.04). PFS in the surgery arm was 12 months versus 11 months in the chemotherapy arm (p = 0.16) with 17% versus 0% 5-year PFS. Grade III-IV morbidity was seen in 42% and 50% of the patients, respectively. No mortalities. Conclusions: Cytoreductive surgery with intraperitoneal chemotherapy may be superior to systemic oxaliplatin-based treatment of colorectal cancer with resectable isolated peritoneal metastases.(ClinicalTrials. gov nr: NCT01524094).</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Cytoreductive surgery
Intraperitoneal chemotherapy
Colorectal cancer
Systemic chemotherapy
Peritoneal metastases
Peritoneal carcinomatosis

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