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Annals of Surgical Oncology
Article . 2018 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Annals of Surgical Oncology
Article
License: CC BY
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Other literature type . 2018
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Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases From a Small Bowel Adenocarcinoma: Multi-Institutional Experience

Authors: Liu, Yang; Yonemura, Yutaka; Levine, Edward; Glehen, Olivier; Goere, Diane; Elias, Dominique; Morris, David; +15 Authors

Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases From a Small Bowel Adenocarcinoma: Multi-Institutional Experience

Abstract

The multi-institutional registry in this study evaluated the outcome after cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal metastases (PM) from small bowel adenocarcinoma (SBA).A multi-institutional data registry including 152 patients with PM from SBA was established. The primary end point was overall survival (OS) after CRS plus HIPEC.Between 1989 and 2016, 152 patients from 21 institutions received a treatment of CRS plus HIPEC. The median follow-up period was 20 months (range 1-100 months). Of the 152 patients, 70 (46.1%) were women with a median age of 54 years. The median peritoneal cancer index (PCI) was 10 (mean 12; range 1-33). Completeness of cytoreduction (CCR) 0 or 1 was achieved for 134 patients (88.2%). After CRS and HIPEC, the median OS was 32 months (range 1-100 months), with survival rates of 83.2% at 1 year, 46.4% at 3 years, and 30.8% at 5 years. The median disease-free survival after CCR 0/1 was 14 months (range 1-100 months). The treatment-related mortality rate was 2%, and 29 patients (19.1%) experienced grades 3 or 4 operative complications. The period between detection of PM and CRS plus HIPEC was 6 months or less (P = 0.008), and multivariate analysis identified absence of lymph node metastasis (P = 0.037), well-differentiated tumor (P = 0.028), and PCI of 15 or lower (P = 0.003) as independently associated with improved OS.The combined treatment strategy of CRS plus HIPEC achieved prolonged survival for selected patients who had PM from SBA with acceptable morbidity and mortality.

Keywords

Male, MESH: Registries, MESH: Lymphatic Metastasis, CARCINOMATOSIS, MESH: Neoplasm Grading, Small, Severity of Illness Index, BIG-RENAPE Group, Postoperative Complications, MESH: Postoperative Complications, Antineoplastic Combined Chemotherapy Protocols, Intestine, Small, Medicine and Health Sciences, MESH: Peritoneal Neoplasms, Registries, Peritoneal Neoplasms, MESH: Hyperthermia, Cancer, MESH: Aged, MESH: Middle Aged, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, DISSEMINATION, Cytoreduction Surgical Procedures, Middle Aged, CANCER, MESH: Intestine, Intestine, Survival Rate, MESH: Antineoplastic Combined Chemotherapy Protocols, Lymphatic Metastasis, Female, 6.4 Surgery, Adult, MESH: Survival Rate, Clinical Sciences, Oncology and Carcinogenesis, 610, [SDV.CAN]Life Sciences [q-bio]/Cancer, Adenocarcinoma, Disease-Free Survival, Rare Diseases, [SDV.CAN] Life Sciences [q-bio]/Cancer, Clinical Research, MESH: Severity of Illness Index, Intestinal Neoplasms, Humans, MESH: Cytoreduction Surgical Procedures, Hyperthermia, Oncology & Carcinogenesis, MESH: Intestinal Neoplasms, Aged, MESH: Humans, Biomedical and Clinical Sciences, Gastrointestinal Oncology, Kirurgi, MESH: Adenocarcinoma, Induced, Evaluation of treatments and therapeutic interventions, MESH: Adult, Oncology and carcinogenesis, Hyperthermia, Induced, MESH: Male, MESH: Disease-Free Survival, Surgery, Neoplasm Grading, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
32
Top 10%
Top 10%
Top 10%
Green
hybrid