1. Cytoreductive surgery and HIPEC improve survival compared to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: A multi-institutional cohort from PSOGI and BIG RENAPE groups
- Author
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I. Amblard, F. Mercier, D.L. Bartlett, S.A. Ahrendt, K.W. Lee, H.J. Zeh, E.A. Levine, D. Baratti, M. Deraco, P. Piso, D.L. Morris, B. Rau, A.A.K. Tentes, J.-J. Tuech, F. Quenet, E. Akaishi, M. Pocard, Y. Yonemura, G. Lorimier, D. Delroeux, L. Villeneuve, O. Glehen, G. Passot, J. Abba, K. Abboud, M. Alyami, C. Arvieux, N. Bakrin, J.-M. Bereder, D. Bouzard, C. Brigand, S. Carrère, F. Dumont, C. Eveno, O. Facy, F. Guyon, R. Kianmanesh, R. Lo Dico, F. Marchal, P. Mariani, P. Meeus, S. Msika, P. Ortega-Deballon, B. Paquette, P. Peyrat, N. Pirro, J. Porcheron, P. Rat, O. Sgarbura, E. Thibaudeau, F. Zinzindohoue, S.H. Baik, A. Bhatt, P. Cachin, W. Ceelen, I. De Hingh, M. De Simone, P. Dubé, R.P. Edwards, J. Franko, L. Gonzalez-Bayon, V. Gushchin, M.P. Holtzman, M.-C. Hsieh, D. Kecmanovic, K. Lehmann, Y. Liu, S. Mehta, S. O'Dwyer, E. Orsevigo, P.K. Pande, E.J. Park, J.F. Pingpank, F. Rajan, A. Sardi, L. Sideris, A. Sommariva, J. Spiliotis, P. Sugarbaker, M. Teo, R. Yarema, R. Younan, S.S. Zaveri, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Chirurgie d'Oncologie Digestive [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Peritoneal metastasis ,medicine.medical_treatment ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Klatskin ,medicine ,Humans ,Prospective Studies ,Registries ,Peritoneal Neoplasms ,Aged ,Aged, 80 and over ,Chemotherapy ,business.industry ,Gallbladder ,Cytoreduction Surgical Procedures ,Hyperthermia, Induced ,General Medicine ,Middle Aged ,Hilar cholangiocarcinoma ,Prognosis ,Gemcitabine ,3. Good health ,Surgery ,Biliary carcinoma ,Survival Rate ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Peritoneal Cancer Index ,Intra-hepatic cholangiocarcinoma ,Female ,Hyperthermic intraperitoneal chemotherapy ,France ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Follow-Up Studies ,medicine.drug - Abstract
Background Peritoneal metastasis from biliary carcinoma (PMC) is associated with poor prognosis when treated with chemotherapy. Objective To evaluate the impact on survival of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and compare with conventional palliative chemotherapy for patients with PMC. Material and methods A prospective multicenter international database was retrospectively searched to identify all patients with PMC treated with a potentially curative CRS/HIPEC (CRS/HIPEC group). The overall survival (OS) was compared to patients with PMC treated with palliative chemotherapy (systemic chemotherapy group). Survival was analyzed using Kaplan-Meier method and compared with Log-Rank test. Results Between 1995 and 2015, 34 patients were included in the surgical group, and compared to 21 in the systemic chemotherapy group. In the surgical group, median peritoneal cancer index was 9 (range 3–26), macroscopically complete resection was obtained for 25 patients (73%). There was more gallbladder localization in the surgical group compared to the chemotherapy group (35% vs. 18%, p = 0.001). Median OS was 21.4 and 9.3 months for surgical and chemotherapy group, respectively (p=0.007). Three-year overall survival was 30% and 10% for surgical and chemotherapy group, respectively. Conclusion Treatment with CRS and HIPEC for biliary carcinoma with peritoneal metastasis is feasible and may provide survival benefit when compared to palliative chemotherapy.
- Published
- 2018
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