1. Long-term survival after hyperthermic intraperitoneal chemotherapy using mitomycin C or oxaliplatin in colorectal cancer patients with synchronous peritoneal metastases: A nationwide comparative study.
- Author
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Bakkers C, van Erning FN, Rovers KP, Nienhuijs SW, Burger JW, Lemmens VE, Aalbers AG, Kok NF, Boerma D, Brandt AR, Hemmer PH, van Grevenstein WM, de Reuver PR, Tanis PJ, Tuynman JB, and de Hingh IH
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma secondary, Adenocarcinoma, Mucinous pathology, Adenocarcinoma, Mucinous secondary, Adenocarcinoma, Mucinous therapy, Aged, Colorectal Neoplasms pathology, Female, Humans, Male, Middle Aged, Netherlands, Peritoneal Neoplasms secondary, Proportional Hazards Models, Survival Rate, Treatment Outcome, Adenocarcinoma therapy, Antineoplastic Agents therapeutic use, Colorectal Neoplasms therapy, Cytoreduction Surgical Procedures, Hyperthermic Intraperitoneal Chemotherapy methods, Mitomycin therapeutic use, Oxaliplatin therapeutic use, Peritoneal Neoplasms therapy
- Abstract
Objectives: In the Netherlands, limited variability exists in performance of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among centers treating colorectal peritoneal metastases (PM), except for the intraperitoneal drug administration. This offers a unique opportunity to investigate any disparities in survival between the two most frequently used HIPEC regimens worldwide: mitomycin C (MMC) and oxaliplatin., Methods: This was a comparative, population-based cohort study of all Dutch patients diagnosed with synchronous colorectal PM who underwent CRS-HIPEC between 2014 and 2017. They were retrieved from the Netherlands Cancer Registry. Main outcome was overall survival (OS). The effect of the intraperitoneal drug on OS was investigated using multivariable Cox regression analysis., Results: In total, 297 patients treated between 2014 and 2017 were included. Among them, 177 (59.6%) received MMC and 120 (40.4%) received oxaliplatin. Only primary tumor location was different between the two groups: more left-sided colon in the Oxaliplatin group (47.5% vs. 33.3%, respectively, p=0.048). The 1-, 2- and 3-year OS were 84.6% vs. 85.8%, 61.6% vs. 63.9% and 44.7% vs. 53.5% in patients treated with MMC and oxaliplatin, respectively. Median OS was 30.7 months in the MMC group vs. 46.6 months in the oxaliplatin group (p=0.181). In multivariable analysis, no influence of intraperitoneal drug on survival was observed (adjusted HR 0.77 [0.53-1.13])., Conclusions: Long-term survival between patients treated with either MMC or oxaliplatin during CRS-HIPEC was not significantly different., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: De Hingh: An unrestricted research grand from RanD/QPS and Roche, paid to the institute., (Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Published
- 2020
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