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Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study

BACKGROUND: There is a paucity of studies evaluating perioperative systemic chemotherapy in conjunction with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer peritoneal metastases (CRCPM). The aim was to evaluate neoadjuvant and/or...

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Autores principales: Cashin, Peter H., Esquivel, Jesus, Larsen, Stein G., Liauw, Winston, Alzahrani, Nayef A., Morris, David L., Kepenekian, Vahan, Sourrouille, Isabelle, Dumont, Frédéric, Tuech, Jean-Jacques, Ceribelli, Cécilia, Doussot, Beranger, Sgarbura, Olivia, Quenet, Francois, Glehen, Olivier, Fisher, Oliver M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706515/
https://www.ncbi.nlm.nih.gov/pubmed/36457647
http://dx.doi.org/10.1016/j.eclinm.2022.101746
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author Cashin, Peter H.
Esquivel, Jesus
Larsen, Stein G.
Liauw, Winston
Alzahrani, Nayef A.
Morris, David L.
Kepenekian, Vahan
Sourrouille, Isabelle
Dumont, Frédéric
Tuech, Jean-Jacques
Ceribelli, Cécilia
Doussot, Beranger
Sgarbura, Olivia
Quenet, Francois
Glehen, Olivier
Fisher, Oliver M.
author_facet Cashin, Peter H.
Esquivel, Jesus
Larsen, Stein G.
Liauw, Winston
Alzahrani, Nayef A.
Morris, David L.
Kepenekian, Vahan
Sourrouille, Isabelle
Dumont, Frédéric
Tuech, Jean-Jacques
Ceribelli, Cécilia
Doussot, Beranger
Sgarbura, Olivia
Quenet, Francois
Glehen, Olivier
Fisher, Oliver M.
author_sort Cashin, Peter H.
collection PubMed
description BACKGROUND: There is a paucity of studies evaluating perioperative systemic chemotherapy in conjunction with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer peritoneal metastases (CRCPM). The aim was to evaluate neoadjuvant and/or adjuvant systemic therapy in CRCPM. METHODS: Patients with CRCPM from 39 treatment centres globally from January 1, 1991, to December 31, 2018, who underwent CRS+HIPEC were identified and stratified according to neoadjuvant/adjuvant use. Crude data analysis, propensity score matching (PSM) and Cox-proportional hazard modelling was performed. FINDINGS: Of 2093 patients, 1613 were included in neoadjuvant crude evaluation with 708 in the PSM cohort (354 patients/arm). In the adjuvant evaluation, 1176 patients were included in the crude cohort with 778 in the PSM cohort (389 patients/arm). The median overall survival (OS) in the PSM cohort receiving no neoadjuvant vs neoadjuvant therapy was 37.0 months (95% CI: 32.6–42.7) vs 34.7 months (95% CI: 31.2–38.8, HR 1.08 95% CI: 0.88–1.32, p = 0.46). The median OS in the PSM cohort receiving no adjuvant therapy vs adjuvant therapy was 37.0 months (95% CI: 32.9–41.8) vs 45.7 months (95% CI: 38.8–56.2, HR 0.79 95% CI: 0.64–0.97, p = 0.022). Recurrence-free survival did not differ in the neoadjuvant evaluation but differed in the adjuvant evaluation – HR 1.04 (95% CI: 0.87–1.25, p = 0.66) and 0.83 (95% CI: 0.70–0.98, p = 0.03), respectively. Multivariable Cox-proportional hazard modelling in the crude cohorts showed hazard ratio 1.08 (95% CI: 0.92–1.26, p = 0.37) for administering neoadjuvant therapy and 0.86 (95% CI: 0.72–1.03, p = 0.095) for administering adjuvant therapy. INTERPRETATION: Neoadjuvant therapy did not confer a benefit to patients undergoing CRS+HIPEC for CRCPM, whereas adjuvant therapy was associated with a benefit in this retrospective setting. FUNDING: None.
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spelling pubmed-97065152022-11-30 Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study Cashin, Peter H. Esquivel, Jesus Larsen, Stein G. Liauw, Winston Alzahrani, Nayef A. Morris, David L. Kepenekian, Vahan Sourrouille, Isabelle Dumont, Frédéric Tuech, Jean-Jacques Ceribelli, Cécilia Doussot, Beranger Sgarbura, Olivia Quenet, Francois Glehen, Olivier Fisher, Oliver M. eClinicalMedicine Articles BACKGROUND: There is a paucity of studies evaluating perioperative systemic chemotherapy in conjunction with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer peritoneal metastases (CRCPM). The aim was to evaluate neoadjuvant and/or adjuvant systemic therapy in CRCPM. METHODS: Patients with CRCPM from 39 treatment centres globally from January 1, 1991, to December 31, 2018, who underwent CRS+HIPEC were identified and stratified according to neoadjuvant/adjuvant use. Crude data analysis, propensity score matching (PSM) and Cox-proportional hazard modelling was performed. FINDINGS: Of 2093 patients, 1613 were included in neoadjuvant crude evaluation with 708 in the PSM cohort (354 patients/arm). In the adjuvant evaluation, 1176 patients were included in the crude cohort with 778 in the PSM cohort (389 patients/arm). The median overall survival (OS) in the PSM cohort receiving no neoadjuvant vs neoadjuvant therapy was 37.0 months (95% CI: 32.6–42.7) vs 34.7 months (95% CI: 31.2–38.8, HR 1.08 95% CI: 0.88–1.32, p = 0.46). The median OS in the PSM cohort receiving no adjuvant therapy vs adjuvant therapy was 37.0 months (95% CI: 32.9–41.8) vs 45.7 months (95% CI: 38.8–56.2, HR 0.79 95% CI: 0.64–0.97, p = 0.022). Recurrence-free survival did not differ in the neoadjuvant evaluation but differed in the adjuvant evaluation – HR 1.04 (95% CI: 0.87–1.25, p = 0.66) and 0.83 (95% CI: 0.70–0.98, p = 0.03), respectively. Multivariable Cox-proportional hazard modelling in the crude cohorts showed hazard ratio 1.08 (95% CI: 0.92–1.26, p = 0.37) for administering neoadjuvant therapy and 0.86 (95% CI: 0.72–1.03, p = 0.095) for administering adjuvant therapy. INTERPRETATION: Neoadjuvant therapy did not confer a benefit to patients undergoing CRS+HIPEC for CRCPM, whereas adjuvant therapy was associated with a benefit in this retrospective setting. FUNDING: None. Elsevier 2022-11-24 /pmc/articles/PMC9706515/ /pubmed/36457647 http://dx.doi.org/10.1016/j.eclinm.2022.101746 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Articles
Cashin, Peter H.
Esquivel, Jesus
Larsen, Stein G.
Liauw, Winston
Alzahrani, Nayef A.
Morris, David L.
Kepenekian, Vahan
Sourrouille, Isabelle
Dumont, Frédéric
Tuech, Jean-Jacques
Ceribelli, Cécilia
Doussot, Beranger
Sgarbura, Olivia
Quenet, Francois
Glehen, Olivier
Fisher, Oliver M.
Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
title Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
title_full Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
title_fullStr Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
title_full_unstemmed Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
title_short Perioperative chemotherapy in colorectal cancer with peritoneal metastases: A global propensity score matched study
title_sort perioperative chemotherapy in colorectal cancer with peritoneal metastases: a global propensity score matched study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706515/
https://www.ncbi.nlm.nih.gov/pubmed/36457647
http://dx.doi.org/10.1016/j.eclinm.2022.101746
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