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Annals of Surgical Oncology

, Volume 21, Issue 13, pp 4195–4201 | Cite as

The American Society of Peritoneal Surface Malignancies (ASPSM) Multiinstitution Evaluation of the Peritoneal Surface Disease Severity Score (PSDSS) in 1,013 Patients with Colorectal Cancer with Peritoneal Carcinomatosis

  • Jesus EsquivelEmail author
  • Andrew M. Lowy
  • Maurie Markman
  • Terence Chua
  • Joerg Pelz
  • Dario Baratti
  • Joel M. Baumgartner
  • Richard Berri
  • Pedro Bretcha-Boix
  • Marcello Deraco
  • Guillermo Flores-Ayala
  • Olivier Glehen
  • 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
  • Richard Trout
Gastrointestinal Oncology

ABSTRACT

Background

Extensive clinical experience suggests that hyperthermic intraperitoneal chemotherapy (HIPEC) may play an important role in the management of colorectal cancer patients with peritoneal carcinomatosis (CRCPC). However, there remains no established nonsurgical process to rationally select patients for this management, either for inclusion/stratification in clinical trials or as a component of standard of care. The Peritoneal Surface Disease Severity Score (PSDSS) was introduced as a basis to improve patient selection.

Methods

The American Society of Peritoneal Surface Malignancies conducted a retrospective review of 1,013 CRCPC patients. The PSDSS was evaluated on 3 specific criteria obtained before surgery (symptoms, extent of peritoneal dissemination, and primary tumor histology). Overall survival was analyzed according to four tiers of disease severity, and a comparison was made between patients who underwent cytoreductive surgery + HIPEC and those who did not.

Results

The PSDSS was calculated on 884 patients (87 %). The median survival of 275 patients not undergoing CRS/HIPEC based on their PSDSS—I (n = 8), II (n = 80), III (n = 55), and IV (n = 132)—was 45, 19, 8, and 6 months, respectively. The median survival of 609 patients who underwent CRS/HIPEC based on their PSDSS—I (n = 75), II (n = 317), III (n = 82), and IV (n = 135)—was 86, 43, 29, and 28 months, respectively.

Conclusions

These data support that the PSDSS, undertaken before surgery, is capable of defining CRCPC populations who have a statistically defined high or considerably lower likelihood of long-term survival after CRS/HIPEC. The PSDSS can be quite useful in the decision to enter CRCPC patients into, and their stratification within, clinical trials.

Keywords

Peritoneal Carcinomatosis Peritoneal Dissemination Aflibercept Peritoneal Cancer Index Complete Cytoreduction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Jesus Esquivel
    • 1
    Email author
  • Andrew M. Lowy
    • 2
  • Maurie Markman
    • 3
  • Terence Chua
    • 4
  • Joerg Pelz
    • 5
  • Dario Baratti
    • 6
  • Joel M. Baumgartner
    • 2
  • Richard Berri
    • 7
  • Pedro Bretcha-Boix
    • 8
  • Marcello Deraco
    • 6
  • Guillermo Flores-Ayala
    • 9
  • Olivier Glehen
    • 10
  • Alberto Gomez-Portilla
    • 11
  • Santiago González-Moreno
    • 12
  • Martin Goodman
    • 13
  • Evgenia Halkia
    • 14
  • Shigeki Kusamura
    • 6
  • Mecker Moller
    • 15
  • Guillaume Passot
    • 10
  • Marc Pocard
    • 16
  • George Salti
    • 17
  • Armando Sardi
    • 18
  • Maheswari Senthil
    • 19
  • John Spilioitis
    • 14
  • Juan Torres-Melero
    • 20
  • Kiran Turaga
    • 21
  • Richard Trout
    • 22
  1. 1.Department of Surgical OncologyCancer Treatment Centers of AmericaPhiladelphiaUSA
  2. 2.Division of Surgical Oncology, Moores Cancer CenterUniversity of CaliforniaSan DiegoUSA
  3. 3.Department of Medical OncologyCancer Treatment Centers of AmericaPhiladelphiaUSA
  4. 4.Hepatobiliary and Surgical Oncology UnitSt. George HospitalSydneyAustralia
  5. 5.Department of SurgeryUniversity of WürzburgWürzburgGermany
  6. 6.Department of SurgeryNational Cancer InstituteMilanItaly
  7. 7.Department of Surgical OncologySt. John HospitalDetroitUSA
  8. 8.General Surgery ServiceHospital San JaimeAlicanteSpain
  9. 9.Department of Surgical OncologyInstituto Jalisciense de CancerologiaGuadalajaraMexico
  10. 10.Department of Surgical OncologyCentre Hospitalier Lyon-SudPierre-BeniteFrance
  11. 11.Department of SurgerySan Jose HospitalVitoriaSpain
  12. 12.Department of Surgical OncologyM. D. Anderson Cancer CenterMadridSpain
  13. 13.Department of Surgical OncologyTufts Medical CenterBostonUSA
  14. 14.Department of GynecologyMetaxa Cancer Memorial HospitalPireusGreece
  15. 15.Department of Surgical OncologyUniversity of MiamiMiamiUSA
  16. 16.Department of SurgeryHospital LariboisiereParisFrance
  17. 17.Department of Surgical OncologyUniversity of IllinoisChampaignUSA
  18. 18.Department of Surgical OncologyMercy Medical CenterBaltimoreUSA
  19. 19.Department of Surgical OncologyLoma Linda University Medical CenterLoma LindaUSA
  20. 20.Department of Surgical OncologyHospital TorrecardenasAlmeriaSpain
  21. 21.Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  22. 22.Department of StatisticsRutgers UniversityNew BrunswickUSA

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