Secondary cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent colorectal peritoneal metastases

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Secondary cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent colorectal peritoneal metastases

Cashin, Peter Harald, 1984- (författare)

Asplund, Dan (författare): Sahlgrens Univ Hosp, Dept Surg, Reg Vastra Gotaland, Gothenburg, Sweden.;Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Surg, Gothenburg, Sweden.

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.

Syk, Ingvar (författare): Skanes Univ Hosp, Malmö, Sweden.

Graf, Wilhelm (författare)

Nilsson, Per J. (författare): Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden.

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.
Ingår i: Surgery Open Science. - : Elsevier. - 2589-8450. ; 20, s. 45-50

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://uu.diva-port... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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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

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Av författaren/redakt...: Cashin, Peter Ha ...; Asplund, Dan; Lindskog, Elinor ...; Ghanipour, Lana; Syk, Ingvar; Graf, Wilhelm; visa fler...; Nilsson, Per J.; Palmer, Gabriell ...; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

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Av lärosätet: Uppsala universitet

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