Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database

Franko, Jan; Shi, Qian; Meyers, Jeffrey P.; Maughan, T; Adams, Rachel; Seymour, Michel; Saltz, Leonard; Punt, Cornelis J.A.; Koopman, Miriam; Tournigand, Christophe; Tebbutt, Niall C.; Díaz-Rubio, Eduardo; Souglakos, John; Falcone, Alfredo; Chibaudel, Benoist; Heinemann, Volker; Moen, Joseph; Gramont, Aimery de; Sargent, Daniel J.; Grothey, Axel

doi:10.1016/s1470-2045(16)30500-9

Cited by 453 publications

(319 citation statements)

References 45 publications

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“…In a recent large-scale study, patients with peritoneal metastatic colorectal cancer had significantly shorter overall survival than those with other isolated sites of metastases [2]. Treatment options are limited, either due to pharmacokinetic limitations of systemic chemotherapy [3, 4] or restricted patient eligibility for cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) due to considerable perioperative morbidity and mortality [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Grass¹,

Martin²,

Montemurro³

et al. 2018

Chemotherapy

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Aims of the Study: The present survey aimed to evaluate current opinion and practice regarding peritoneal metastasis (PM), satisfaction with available treatment options, and need for new therapeutic approaches. Methods: This was a qualitative study conducted between October 2016 and October 2017 in the Réseau Suisse Romand d’Oncologie including 101 members of various oncological specialties. Participants’ demographics, current practice, knowledge, and satisfaction regarding available treatment options and need for new treatment options were assessed by semantic differential scales through 33 closed questions with automatic reminders at 4-, 8-, 12-, and 16-week intervals. Results: Twenty-seven participants (27%) completed the survey. Participants were gastrointestinal or gynecologic oncologists and surgeons. Most participants (67%) evaluated their knowledge on PM as moderate, while 22% considered themselves as experts. Clinical usefulness of systemic chemotherapy and hyperthermic intraperitoneal chemotherapy was judged to be moderate to high for PM of ovarian and colorectal origin and moderate to poor for gastric origin. Satisfaction with available treatment options was 6/10 (interquartile range [IQR] 4–7) for ovarian, 5/10 (IQR 3–7) for colorectal, and 3/10 (IQR 1–3) for gastric PM. Treatment strategies varied widely for typical case vignettes. The need for new treatment modalities was rated as 8/10 (IQR 6–10). Conclusion: Usefulness of and satisfaction with available treatment options for PM were rated as moderate at best by oncological experts, and treatment strategies differed importantly among participants. There appears to be a clear need for standardization and new treatment modalities.

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Section: Introductionmentioning

confidence: 99%

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Grass¹,

Martin²,

Montemurro³

et al. 2018

Chemotherapy

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“…In the ARCAD study the probability of survival for patients with peritoneal metastases was significantly worse compared with single organ non-peritoneal metastases (adjusted HR = 0.73, p = 0.012 and 0.61, p < 0.001 for liver and lung metastases, respectively), but the difference was not significant when subgroup analysis performed between the patients with isolated peritoneal involvement and patients with metastases in two non-peritoneal organs (adjusted HR = 1.10, p = 0.37). 22 …”

Section: Discussionmentioning

confidence: 99%

Sixteen Years of Experience with the Treatment of Advanced Colorectal Cancer in Iran; A Report from Three Institutions

Jalaeikhoo

Khajeh-Mehrizi

Zokaasadi

et al. 2018

Middle East J Dig Dis

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BACKGROUND Colorectal cancer (CRC) is one of the most common cancers worldwide. Recently treatments of advanced CRC have been immensely improved. In this study we reported the current state of advanced CRC in Iran regarding treatment and outcomes from 2000 to 2016. METHODS 370 subjects with stage III or IV of the disease were included in this study. Pathological subtypes other than adenocarcinoma were excluded. Demographics and other relevant clinical data were collected. RESULTS Mean age at diagnosis was 55.4 ± 12.6 years. Significant differences regarding the age, sex, primary tumor complication and location, lymph node involvement, and tumor size were not detected between patients with stage III and IV. Overall survival rate at 5 years was 69.5% (95% confidence interval: 60.8% - 76.6%) and 21.73% (95% CI: 12.46% - 32.70%) for patients with stage III and IV, respectively. Analysis of prognostic factors revealed that tumor grade was an independent factor predicting poorer outcome (poorly differentiated vs. well or moderately differentiated). Furthermore, in stage IV of the disease, IVb subgroup was found to be associated with a poorer outcome compared with stage IVa. CONCLUSION Even with the acceptable survival rates and more effective treatments, it seems that clinicopathological characteristics have yet the most important prognostic effect in advanced CRC.

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“…Curative intent surgery played a minor role in the treatment, which mainly focused on symptom relief. The efficacy of palliative systemic chemotherapy for colorectal PM remains less evident than its efficacy for other colorectal cancer metastases 22. Population-based studies reported median survival rates of up to 12 months in patients with colorectal PM who were treated with palliative systemic therapy 23.…”

Section: Systemic Treatment Of Colorectal Pmmentioning

confidence: 99%

“…However, a pooled subgroup analysis of randomized studies in advanced colorectal cancer endorses the dogma that colorectal PM are relatively resistant to systemic therapy compared to other isolated sites of metastases 22. By using Blazer’s classification, Passot et al reported a complete and major pathological response rate of 10% and 20%, which was lower than the reported pathological response rates of colorectal liver metastases 79–81.…”

Section: Neo-adjuvant Systemic Treatmentmentioning

confidence: 99%

Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer

Simkens

Rovers

Nienhuijs

et al. 2017

CMAR

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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a viable option for selected patients with peritoneal metastases (PM) from colorectal origin, resulting in long-term survival and even cure in some cases. However, adequate patient selection for this treatment is currently one of the major challenges. The aim of this review is to provide a comprehensive overview of clinically relevant factors associated with overall survival. This may help to guide clinicians through the complex interplay of patient, tumor, and treatment characteristics to adequately select patients who benefit the most from this extensive surgical treatment. First, basic principles of colorectal PM and the CRS and HIPEC treatment will be discussed. According to available literature, especially extent of peritoneal disease, completeness of cytoreduction, and signet ring cell histology have great influence on the outcome after CRS and HIPEC. Other factors that seem to have a negative prognostic value are the presence of liver metastases and the absence of treatment with neo-adjuvant systemic therapy. Prognostic models combining the above-mentioned factors, such as the Colorectal Peritoneal Metastases Prognostic Surgical Score nomogram, may provide clinically relevant tools to use in everyday practice.

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Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database

Abstract: None.

Cited by 453 publications

References 45 publications

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Sixteen Years of Experience with the Treatment of Advanced Colorectal Cancer in Iran; A Report from Three Institutions

Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer

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