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Outcomes of preoperative chemotherapy for colorectal cancer with peritoneal metastasis underwent cytoreductive surgery

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Abstract

Background

This study aims to assess and compare the extent to which preoperative chemotherapy prior to CRS improves survival in patients diagnosed with CRCPM.

Methods

We included 251 patients from 2012 to 2019 in our center. Inverse probability of treatment weighting (IPTW) analysis was used to minimize the selection bias. Survival analysis was performed to compare the survival outcomes. Multivariate Cox regression analysis was conducted to identify prognostic factors.

Result

The baseline characteristics were well balanced using IPTW (standardized mean difference < 0.1). Preoperative chemotherapy cannot significantly improve overall survival (HR, 1.03; 95% CI 0.71–1.49; P = 0.88). In subgroup analysis, we found that intestinal obstruction after preoperative chemotherapy significantly reduced survival (HR, 2.25; 95% CI 1.01–5.03; P = 0.048), while in the upfront surgery group, intestinal obstruction had no impact on prognosis.

Conclusion

For CRCPM patients treated with CRS, preoperative chemotherapy does not seem to prolong overall survival. Furthermore, the emergence of intestinal obstruction after chemotherapy may compromise the effectiveness of treatment, resulting in a worse prognosis. This finding has important clinical implications for treatment decisions.

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Data availability statement

The data that support the findings of this study are available from the corresponding author, Rui Luo, upon reasonable request.

Change history

  • 13 July 2023

    The original online version of this article was revised to correct the email address of author, Yanli Wang.

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Acknowledgements

This study was supported by National Key Clinical Discipline.

Funding

This study was funded by The Sixth Affiliated Hospital of Sun Yat-Sen University Clinical Research- “1010” Program: 1010CG (2022)-08 and Guangdong Provincial Clinical Research Center for Digestive Diseases: 2020B1111170004.

Author information

Author notes

  1. Binying Peng, Zhiying Liu, and Binjie Huang have contributed equally to this work.

Authors and Affiliations

  1. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China

    Binying Peng, Zhiying Liu & Yiwen Su

  2. Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China

    Binjie Huang, Yuanxin Zhang, Hui Wang & Rui Luo

  3. Department of Anesthesiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China

    Yanli Wang

Authors
  1. Binying Peng
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  4. Yuanxin Zhang
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  7. Yanli Wang
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Contributions

Manuscript design: Rui Luo and Yanli Wang. Data analysis and interpretation: Binying Peng, Zhiying Liu and Binjie Huang. Manuscript writing: all authors. Final approval of manuscript: all authors.

Corresponding authors

Correspondence to Yanli Wang or Rui Luo.

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Conflict of interest

The authors disclose no potential conflicts of interest.

Ethical approval

The studies involving human participants were reviewed and approved by The Ethics Committees of The Sixth Affiliated Hospital (No. 2020ZSLYEC-109). The data are amomymous, and the requirement for informed consent was therefore waived.

Research involving human participants and/or animals and Informed consent

The studies involving human participants were reviewed and approved by The Ethics Committees of The Sixth Affiliated Hospital (No. 2020ZSLYEC-109). This study will not expose the patient's personal privacy information and the data are anonymous. Therefore the requirement for informed consent was waived, which is a characteristic of the retrospective study design.

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Peng, B., Liu, Z., Huang, B. et al. Outcomes of preoperative chemotherapy for colorectal cancer with peritoneal metastasis underwent cytoreductive surgery. Clin Transl Oncol 26, 269–277 (2024). https://doi.org/10.1007/s12094-023-03250-1

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  • DOI: https://doi.org/10.1007/s12094-023-03250-1

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