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Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The prognosis of peritoneal carcinomatosis (PC) from colorectal cancer has been improved with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, benefits of postoperative chemotherapy (CT) are unclear.

Methods

This retrospective, multicenter study included 231 patients treated by CRS and HIPEC for isolated PC of colon cancer in four expert’s centers. Overall survival (OS), progression-free survival (PFS), and peritoneal recurrence-free survival (PRFS) were compared between patients with adjuvant CT (started within 3 months after surgery) and patients with surveillance only.

Results

After exclusion of 10 patients for early postoperative death (4 %), 221 patients were included (CT group: n = 151; surveillance group: n = 70). Main postoperative CT regimens (median of 6 cycles) were Folfox (28 %), Folfiri bevacizumab (24.5 %), Folfiri (16 %), and Folfiri cetuximab (12.5 %). The median OS after surgery was 43.3 months with no difference between CT and surveillance groups. In multivariate analysis, a low peritoneal cancer index (p < 0.0001) and a long delay between diagnosis of CP and HIPEC (p = 0.001) were associated with increased OS. The median PFS and PRFS were 12.4 and 17 months, respectively. At 1 year, more patients were without progression (p = 0.001) or PC recurrence (0.0004) in the CT group, but with prolonged follow-up this difference was no longer significant.

Conclusions

Early postoperative CT does not improve OS after CRS and HIPEC for colon carcinomatosis. However, a transient effect on PFS and PRFS was observed. A subgroup of patients who may benefit more from CT remain to be defined.

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Acknowledgments

The authors thank Isabelle Bonnefoy for all the help provided during the study.

Conflict of interest

The authors declared no conflict of interest of any kind for this study.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, AP-HP, Hopital Saint Louis, Université Paris-Diderot (USPC), Paris, France

    Marianne Maillet MD, Nelson Lourenco MD & Jean-Marc Gornet MD

  2. Department of Digestive Surgery CHU de Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France

    Olivier Glehen MD, PhD & Guillaume Passot MD, PhD

  3. Department of Biostatistics, AP-HP, Hopital Saint Louis, Université Paris-Diderot (USPC), Paris, France

    Jerome Lambert MD, PhD

  4. Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France

    Diane Goere MD, PhD & Dominique Elias MD, PhD

  5. Surgical Oncologic & Digestive Unit, AP-HP, Hôpital Lariboisière, Université Paris-Diderot (USPC), Paris, France

    Marc Pocard MD, PhD & Clarisse Eveno MD, PhD

  6. Department of Digestive Surgery, AP-HP, Hôpital Louis Mourier, Université Paris-Diderot (USPC), Colombes, France

    Simon Msika MD, PhD

  7. Department of Hepato-Gastroenterology, AP-HP, Hôpital Louis Mourier, Université Paris-Diderot (USPC), Colombes, France

    Jean-Marc Sabaté MD, PhD

  8. Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, Université Pierre et Marie Curie (UMPC), Paris, France

    Thierry André MD

Authors
  1. Marianne Maillet MD
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  2. Olivier Glehen MD, PhD
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  3. Jerome Lambert MD, PhD
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  4. Diane Goere MD, PhD
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  5. Marc Pocard MD, PhD
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  6. Simon Msika MD, PhD
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  7. Guillaume Passot MD, PhD
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  8. Dominique Elias MD, PhD
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  9. Clarisse Eveno MD, PhD
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  10. Jean-Marc Sabaté MD, PhD
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  11. Nelson Lourenco MD
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  12. Thierry André MD
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  13. Jean-Marc Gornet MD
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BIG-RENAPE Working Group

Corresponding author

Correspondence to Jean-Marc Gornet MD.

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Maillet, M., Glehen, O., Lambert, J. et al. Early Postoperative Chemotherapy After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Isolated Peritoneal Carcinomatosis of Colon Cancer: A Multicenter Study. Ann Surg Oncol 23, 863–869 (2016). https://doi.org/10.1245/s10434-015-4914-4

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  • DOI: https://doi.org/10.1245/s10434-015-4914-4

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