Population-based survival of patients with peritoneal carcinomatosis from colorectal origin in the era of increasing use of palliative chemotherapy

Klaver, Y.L.B.; Lemmens, Valery; Creemers, G.J.; Rutten, H.J.T.; Nienhuijs, Simon W.; Hingh, Ignace H. J. T. de

doi:10.1093/annonc/mdq762

Cited by 83 publications

(50 citation statements)

References 26 publications

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“…The total group of patients with PC and their treatment in the Eindhoven Cancer Registry area has been described elsewhere. 16 Between 2000 and 2008, 50 consecutive patients (32 male, mean age 65 y) synchronously diagnosed with PC who received palliative chemotherapeutic treatment were identified and included in the study. Patient and tumor characteristics are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Addition of Biological Therapies to Palliative Chemotherapy Prolongs Survival in Patients With Peritoneal Carcinomatosis of Colorectal Origin

Klaver¹,

Leenders²,

Creemers

et al. 2013

American Journal of Clinical Oncology

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Section: Resultsmentioning

confidence: 99%

Addition of Biological Therapies to Palliative Chemotherapy Prolongs Survival in Patients With Peritoneal Carcinomatosis of Colorectal Origin

Klaver¹,

Leenders²,

Creemers

et al. 2013

American Journal of Clinical Oncology

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“…37 Current standards involve systemic chemotherapy and an increasing role of cytoreductive surgery and HIPEC (Hyperthermic Intraperitoneal Chemotherapy). 38 Prior work has highlighted the poor prognosis for CRC patients with peritoneal metastases and potentially improved outcomes with Oxaliplatin based therapy in an unselected population.…”

Section: Discussionmentioning

confidence: 99%

Molecular profiling of 6,892 colorectal cancer samples suggests different possible treatment options specific to metastatic sites

El‐Deiry

Vijayvergia

Xiu

et al. 2015

Cancer Biology & Therapy

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Metastatic colorectal cancer (mCRC) carries a poor prognosis with an overall 5-year survival of 13.1%. Therapies guided by tumor profiling have suggested benefit in advanced cancer. We used a multiplatform molecular profiling (MP) approach to identify key molecular changes that may provide therapeutic options not typically considered in mCRC. We evaluated 6892 mCRC referred to Caris Life Sciences by MP including sequencing (Sanger/NGS), immunohistochemistry (IHC) and in-situ hybridization (ISH). mCRC metastases to liver, brain, ovary or lung (n D 1507) showed differential expression of markers including high protein expression of TOPO1 (52%) and/or low RRM1 (57%), TS (71%) and MGMT (39%), suggesting possible benefit from irinotecan, gemcitabine, 5FU/capecitabine and temozolomide, respectively. Lung metastases harbored a higher Her2 protein expression than the primary colon tumors (4% vs. 1.8%, p D 0.028). Brain and lung metastases had higher KRAS mutations than other sites (65% vs 59% vs 47%, respectively, p D 0.07, <0.01), suggesting poor response to anti-EGFR therapies. BRAF-mutated CRC (n D 455) showed coincident high protein expression of RRM1 (56%), TS (53%) and low PDGFR (22%) as compared with BRAF wild-type tumors. KRAS-mutated mCRC had higher protein expression of c-MET (47% vs. 36%) and lower MGMT (56% vs. 63%), suggesting consideration of c-MET inhibitors and temozolomide. KRAS-mutated CRC had high TUBB3 (42% vs. 33%) and low Her2 by IHC (0.5%) and HER2 by FISH (3%, p <0.05). CRC primaries had a lower incidence of PIK3CA and BRAF mutations in rectal cancer versus colon cancer (10% and 3.3%, respectively). MP of 6892 CRCs identified significant differences between primary and metastatic sites and among BRAF/KRAS sub-types. Our findings are hypothesis generating and need to be examined in prospective studies. Specific therapies may be considered for different actionable targets in mCRC as revealed by MP.

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“…There are a number of studies showing the positive impact of CRS and HIPEC on oncologic outcomes of patients with CRC, approximately 10% of which present with PC at the time of diagnosis (Table 1) (15,17,19,20,(44)(45)(46)(47) innovations such as targeted therapy, the results of systemic chemotherapy alone are still worse than that of CRS and HIPEC (48). Full-cytoreduction and PCI scores are the most powerful prognostic factors for survival.…”

Section: Discussionmentioning

confidence: 99%

Cytoreductive surgery (SRC) for treatment of peritoneal carcinomatosis and hyperthermic ıntraperitoneal chemotherapy (HIPEC): Our initial experience and technical details

Topgül

Çetinkaya

Arslan

et al. 2015

UCD

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Objective: The aim of this study is to present our initial experience in peritoneal carcinomatosis treatment and the technical details of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the light of current literature. Material and Methods:Data of 27 consecutive patients who were treated with CRS and HIPEC for peritoneal carcinomatosis in Medical Park Samsun Hospital, between November 2012 and September 2014 were retrospectively reviewed. Treatment indication and management were evaluated at the multidisciplinary oncology council. All patients underwent CRS and HIPEC with the aim of complete cytoreduction. Patients with unresectable disease and/or palliative surgery were excluded from analysis. Perioperative complications were classified according to Clavien-Dindo classification, and HIPEC-related side effects were identified using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) criteria. Demographic, clinical and histopathological data of the patients were analyzed. Results:The mean age was 54 (32-72). Nineteen patients were female. The origin of peritoneal carcinomatosis was colorectal cancer in 12 patients, ovarian cancer in 12 patients, gastric cancer in 2 patients and pseudomyxoma peritonei in 1 patient. The mean Peritoneal Carcinomatosis Index was 12 (3-32), with a mean operative time of 420 (300-660) minutes. Perioperative morbidity, HIPEC-related toxicity and perioperative mortality were observed in eight (30%), one (3.7%) and four patients (14.8%), respectively. During a mean follow up of 13 (1-22) months, overall and disease-free survival rates were 95.8% and 82.6%, respectively. Two patients with colorectal cancer (after 9 and 12 months) and one patient with ovarian cancer (after 11 months) had intra-abdominal recurrence. One patient with ovarian cancer had liver metastases 13 months after surgery, and underwent resection of segments 6-7. The remaining patients are being followed-up without any recurrence. Conclusion:Cytoreductive surgery and HIPEC have favorable results in the treatment of patients with peritoneal carcinomatosis. Compatible with the literature, surgical outcomes of the presented series are encouraging for this treatment modality that have been recently popularized in our country. Careful perioperative evaluation, proper patient selection and multidisciplinary approach are essential for success in curative treatment of peritoneal carcinomatosis.

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Population-based survival of patients with peritoneal carcinomatosis from colorectal origin in the era of increasing use of palliative chemotherapy

Abstract: Despite increasing usage of palliative chemotherapy and availability of new agents, population-based survival of patients with PC did not improve until very recently. Response to palliative chemotherapy in PC should be evaluated separately from haematogenous metastases.

Cited by 83 publications

References 26 publications

Addition of Biological Therapies to Palliative Chemotherapy Prolongs Survival in Patients With Peritoneal Carcinomatosis of Colorectal Origin

Addition of Biological Therapies to Palliative Chemotherapy Prolongs Survival in Patients With Peritoneal Carcinomatosis of Colorectal Origin

Molecular profiling of 6,892 colorectal cancer samples suggests different possible treatment options specific to metastatic sites

Cytoreductive surgery (SRC) for treatment of peritoneal carcinomatosis and hyperthermic ıntraperitoneal chemotherapy (HIPEC): Our initial experience and technical details

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