Hyperthermic intraperitoneal chemotherapy in colorectal cancer

Oliver M. Fisher; Chris Brown; Jesus Esquivel; Stein G. Larsen; Winston Liauw; Nayef A. Alzahrani; David L. Morris; Vahan Kepenekian; Isabelle Sourrouille; Frédéric Dumont; Jean Jacques Tuech; Cécilia Ceribelli; Béranger Doussot; Olivia Sgarbura; Mohammed Alhosni; Francois Quenet; Olivier Glehen; Peter H. Cashin; Kjersti Flatmark; Wilhelm Graf; Heikki Takala; Andrew M. Lowy; Terence Chua; Joerg Pelz; Dario Baratti; Joel M. Baumgartner; Richard Berri; Pedro Bretcha-Boix; Marcello Deraco; Guillermo Flores-Ayala; Alberto Gomez-Portilla; Santiago González-Moreno; Martin Goodman; Evgenia Halkia; Shigeki Kusamura; Mecker Moller; Guillaume Passot; Marc Pocard; George Salti; Armando Sardi; Maheswari Senthil; John Spilioitis; Juan Torres-Melero; Kiran Turaga; Jean Marc Bereder; Jean Louis Bernard; Naoual Bakrin; Sébastien Carrère; Julien Coget; Eddy Cotte; Olivier Facy; Maximiliano Gelli; François Noël Gilly; Pablo Ortega-Deballon; Patrick Rat; Pascal Rousset; Emilie Thibaudeau; Delphine Vaudoyer

doi:10.1093/bjsopen/zrae017

Hyperthermic intraperitoneal chemotherapy in colorectal cancer

Oliver M. Fisher, Chris Brown, Jesus Esquivel, Stein G. Larsen, Winston Liauw, Nayef A. Alzahrani, David L. Morris, Vahan Kepenekian, Isabelle Sourrouille, Frédéric Dumont, Jean Jacques Tuech, Cécilia Ceribelli, Béranger Doussot, Olivia Sgarbura, Mohammed Alhosni, Francois Quenet, Olivier Glehen, Peter H. Cashin, Kjersti Flatmark, Wilhelm GrafHeikki Takala, Andrew M. Lowy, Terence Chua, Joerg Pelz, Dario Baratti, Joel M. Baumgartner, Richard Berri, Pedro Bretcha-Boix, Marcello Deraco, Guillermo Flores-Ayala, Alberto Gomez-Portilla, Santiago González-Moreno, Martin Goodman, Evgenia Halkia, Shigeki Kusamura, Mecker Moller, Guillaume Passot, Marc Pocard, George Salti, Armando Sardi, Maheswari Senthil, John Spilioitis, Juan Torres-Melero, Kiran Turaga, Jean Marc Bereder, Jean Louis Bernard, Naoual Bakrin, Sébastien Carrère, Julien Coget, Eddy Cotte, Olivier Facy, Maximiliano Gelli, François Noël Gilly, Pablo Ortega-Deballon, Patrick Rat, Pascal Rousset, Emilie Thibaudeau, Delphine Vaudoyer

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Résumé

Background: This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients. Patients and Methods: Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received - oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed. Results: Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period. Conclusions: Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported.

langue originale	Anglais
Numéro d'article	zrae017
journal	BJS Open
Volume	8
Numéro de publication	3
Les DOIs	https://doi.org/10.1093/bjsopen/zrae017
état	Publié - 1 juin 2024

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10.1093/bjsopen/zrae017

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Fisher, O. M., Brown, C., Esquivel, J., Larsen, S. G., Liauw, W., Alzahrani, N. A., Morris, D. L., Kepenekian, V., Sourrouille, I., Dumont, F., Tuech, J. J., Ceribelli, C., Doussot, B., Sgarbura, O., Alhosni, M., Quenet, F., Glehen, O., Cashin, P. H., Flatmark, K., ... Vaudoyer, D. (2024). Hyperthermic intraperitoneal chemotherapy in colorectal cancer. BJS Open, 8(3), Article zrae017. https://doi.org/10.1093/bjsopen/zrae017

@article{28f707b20ba94ce4bf02aae59d945056,

title = "Hyperthermic intraperitoneal chemotherapy in colorectal cancer",

abstract = "Background: This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients. Patients and Methods: Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received - oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed. Results: Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period. Conclusions: Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported.",

author = "Fisher, {Oliver M.} and Chris Brown and Jesus Esquivel and Larsen, {Stein G.} and Winston Liauw and Alzahrani, {Nayef A.} and Morris, {David L.} and Vahan Kepenekian and Isabelle Sourrouille and Fr{\'e}d{\'e}ric Dumont and Tuech, {Jean Jacques} and C{\'e}cilia Ceribelli and B{\'e}ranger Doussot and Olivia Sgarbura and Mohammed Alhosni and Francois Quenet and Olivier Glehen and Cashin, {Peter H.} and Kjersti Flatmark and Wilhelm Graf and Heikki Takala and Lowy, {Andrew M.} and Terence Chua and Joerg Pelz and Dario Baratti and Baumgartner, {Joel M.} and Richard Berri and Pedro Bretcha-Boix and Marcello Deraco and Guillermo Flores-Ayala and Alberto Gomez-Portilla and Santiago Gonz{\'a}lez-Moreno and Martin Goodman and Evgenia Halkia and Shigeki Kusamura and Mecker Moller and Guillaume Passot and Marc Pocard and George Salti and Armando Sardi and Maheswari Senthil and John Spilioitis and Juan Torres-Melero and Kiran Turaga and Bereder, {Jean Marc} and Bernard, {Jean Louis} and Naoual Bakrin and S{\'e}bastien Carr{\`e}re and Julien Coget and Eddy Cotte and Olivier Facy and Maximiliano Gelli and Gilly, {Fran{\c c}ois No{\"e}l} and Pablo Ortega-Deballon and Patrick Rat and Pascal Rousset and Emilie Thibaudeau and Delphine Vaudoyer",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Published by Oxford University Press on behalf of BJS Foundation Ltd.",

year = "2024",

month = jun,

day = "1",

doi = "10.1093/bjsopen/zrae017",

language = "English",

volume = "8",

journal = "BJS Open",

issn = "2474-9842",

number = "3",

}

Fisher, OM, Brown, C, Esquivel, J, Larsen, SG, Liauw, W, Alzahrani, NA, Morris, DL, Kepenekian, V, Sourrouille, I, Dumont, F, Tuech, JJ, Ceribelli, C, Doussot, B, Sgarbura, O, Alhosni, M, Quenet, F, Glehen, O, Cashin, PH, Flatmark, K, Graf, W, Takala, H, Lowy, AM, Chua, T, Pelz, J, Baratti, D, Baumgartner, JM, Berri, R, Bretcha-Boix, P, Deraco, M, Flores-Ayala, G, Gomez-Portilla, A, González-Moreno, S, Goodman, M, Halkia, E, Kusamura, S, Moller, M, Passot, G, Pocard, M, Salti, G, Sardi, A, Senthil, M, Spilioitis, J, Torres-Melero, J, Turaga, K, Bereder, JM, Bernard, JL, Bakrin, N, Carrère, S, Coget, J, Cotte, E, Facy, O, Gelli, M, Gilly, FN, Ortega-Deballon, P, Rat, P, Rousset, P, Thibaudeau, E & Vaudoyer, D 2024, 'Hyperthermic intraperitoneal chemotherapy in colorectal cancer', BJS Open, VOL. 8, Numéro 3, zrae017. https://doi.org/10.1093/bjsopen/zrae017

TY - JOUR

T1 - Hyperthermic intraperitoneal chemotherapy in colorectal cancer

AU - Fisher, Oliver M.

AU - Brown, Chris

AU - Esquivel, Jesus

AU - Larsen, Stein G.

AU - Liauw, Winston

AU - Alzahrani, Nayef A.

AU - Morris, David L.

AU - Kepenekian, Vahan

AU - Sourrouille, Isabelle

AU - Dumont, Frédéric

AU - Tuech, Jean Jacques

AU - Ceribelli, Cécilia

AU - Doussot, Béranger

AU - Sgarbura, Olivia

AU - Alhosni, Mohammed

AU - Quenet, Francois

AU - Glehen, Olivier

AU - Cashin, Peter H.

AU - Flatmark, Kjersti

AU - Graf, Wilhelm

AU - Takala, Heikki

AU - Lowy, Andrew M.

AU - Chua, Terence

AU - Pelz, Joerg

AU - Baratti, Dario

AU - Baumgartner, Joel M.

AU - Berri, Richard

AU - Bretcha-Boix, Pedro

AU - Deraco, Marcello

AU - Flores-Ayala, Guillermo

AU - Gomez-Portilla, Alberto

AU - González-Moreno, Santiago

AU - Goodman, Martin

AU - Halkia, Evgenia

AU - Kusamura, Shigeki

AU - Moller, Mecker

AU - Passot, Guillaume

AU - Pocard, Marc

AU - Salti, George

AU - Sardi, Armando

AU - Senthil, Maheswari

AU - Spilioitis, John

AU - Torres-Melero, Juan

AU - Turaga, Kiran

AU - Bereder, Jean Marc

AU - Bernard, Jean Louis

AU - Bakrin, Naoual

AU - Carrère, Sébastien

AU - Coget, Julien

AU - Cotte, Eddy

AU - Facy, Olivier

AU - Gelli, Maximiliano

AU - Gilly, François Noël

AU - Ortega-Deballon, Pablo

AU - Rat, Patrick

AU - Rousset, Pascal

AU - Thibaudeau, Emilie

AU - Vaudoyer, Delphine

PY - 2024/6/1

Y1 - 2024/6/1

N2 - Background: This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients. Patients and Methods: Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received - oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed. Results: Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period. Conclusions: Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported.

AB - Background: This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients. Patients and Methods: Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received - oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed. Results: Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period. Conclusions: Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported.

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U2 - 10.1093/bjsopen/zrae017

DO - 10.1093/bjsopen/zrae017

M3 - Article

C2 - 38722737

AN - SCOPUS:85192824966

SN - 2474-9842

VL - 8

JO - BJS Open

JF - BJS Open

IS - 3

M1 - zrae017

ER -