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Secondary cytoreduc...
Secondary cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent colorectal peritoneal metastases
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Cashin, Peter Harald, 1984- (författare)
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- Asplund, Dan (författare)
- Sahlgrens Univ Hosp, Dept Surg, Reg Vastra Gotaland, Gothenburg, Sweden.;Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Surg, Gothenburg, Sweden.
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- Lindskog, Elinor Bexe (författare)
- Sahlgrens Univ Hosp, Dept Surg, Reg Vastra Gotaland, Gothenburg, Sweden.
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- Ghanipour, Lana (författare)
- Uppsala Univ Hosp, Uppsala, Sweden.
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- Syk, Ingvar (författare)
- Skanes Univ Hosp, Malmö, Sweden.
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Graf, Wilhelm (författare)
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- Nilsson, Per J. (författare)
- Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden.
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- Palmer, Gabriella Jansson (författare)
- Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden.
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Sahlgrens Univ Hosp, Dept Surg, Reg Vastra Gotaland, Gothenburg, Sweden;Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Surg, Gothenburg, Sweden. Sahlgrens Univ Hosp, Dept Surg, Reg Vastra Gotaland, Gothenburg, Sweden. (creator_code:org_t)
- Elsevier, 2024
- 2024
- Engelska.
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Ingår i: Surgery Open Science. - : Elsevier. - 2589-8450. ; 20, s. 45-50
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background:Secondary treatment of recurrent colorectal peritoneal metastases after previous cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is poorly investigated.Objectives:To evaluate the overall survival outcome of secondary (repeat) CRS + HIPEC compared to palliative treatment in recurrent peritoneal disease.Methods:Patients with colorectal peritoneal metastases treated with an index CRS + HIPEC and subsequently having recurrent peritoneal disease were identified from the prospective Swedish national HIPEC registry. Patients were divided into interventional group (secondary CRS + HIPEC) or palliative group. Multivariable logistic regression, propensity-score matching, and survival outcomes were calculated.Results:Among 575 patients who underwent complete CRS between 2010 and 2021, 208 (36 %) were diagnosed with a subsequent recurrent peritoneal disease. Forty-two patients (20 %) were offered secondary CRS + HIPEC. Propensity-score matching of secondary interventional cases with palliative cases succeeded in 88 % (n = 37) in which female sex, lower peritoneal cancer index at index surgery, longer disease-free interval, and absence of extra-peritoneal metastases were identified as the most relevant matching covariates. Median OS from date of recurrence was 38 months (95%CI 30-58) in the interventional group and 19 months (95%CI: 15-24) in the palliative group (HR 0.35 95%CI: 0.20-0.63, p = 0.0004). Sensitivity analyses confirmed the results. As reference, the median OS from index CRS + HIPEC in the whole colorectal registry (n = 575) was 41 months (95%CI: 38-45).Conclusion:After matching for relevant factors, the hazard ratio for death was significantly reduced in patients who were offered a secondary CRS + HIPEC procedure for recurrent peritoneal disease. Selection bias is inherent, but survival outcomes were comparable to those achieved after the initial procedure.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Colorectal cancer
- Peritoneal metastases
- Cytoreductive surgery
- Hyperthermic intraperitoneal chemotherapy
- Relapse treatment
- Systemic chemotherapy
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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