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HIPEC in T4a colon cancer: a defendable treatment to improve oncologic outcome?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Hompes, Daphne Tiek, Joyce Wolthuis, A. M. Fieuws, Steffen Penninckx, Freddy M. Cutsem, Eric Van D'Hoore, André |
| Copyright Year | 2012 |
| Abstract | BACKGROUND Adequate estimation of the potential benefits of 'adjuvant' hyperthermia and intraperitoneal chemotherapy (HIPEC) in T4 patients through assessment of the burden of peritoneal carcinomatosis (PC) in T4 tumors and the risk of PC as the only metastatic site. PATIENTS AND METHODS Analysis of prospectively collected data on patients who underwent surgery for colon cancer (Jan 2004-Jan 2007). RESULTS About 379 patients (M/F = 204/175) were included, with a median age of 71.8 years (range 35.4-95.0): 39 stage I, 126 stage II, 89 stage III, 116 stage IV disease (+9 with unknown stage). The median follow-up was 34.8months [range 0.0-79.4]. The 3- and 5-year overall survival rates (OS) were 68.4% (95% confidence interval (CI) 63.9%-72.4%) and 60.3% (95%CI 55.6%-64.7%). Relapse analysis was restricted to stages II-III T3 (N = 154) and T4 tumors (N = 19) with complete relapse data, of which 13.2% developed PC. PC has a detrimental effect on OS [HR 6.3 (95%CI: 3.1-13.0, P < 0.0001)]. 50% of T4a and 20% of T4b developed PC. The 1- and 3-year PC percentage was significantly lower for T3 (4.5% and 9.3%) than T4 tumors (15.6% and 36.7%) (P = 0.008). PC was the only metastatic site in 3/15 T3 [proportion 0.20, 95%CI (0.043-0.481)] and 5/8 T4 tumors with PC [proportion 0.625, 95%CI (0.245-0.915)] (P = 0.071). CONCLUSIONS T4a colon tumors have a significantly higher risk of developing PC. Twenty-five percent (5/19) of stages II-III T4 tumors develop PC as the only metastatic site. This could define the possible window of opportunity for adjuvant HIPEC to prevent PC. |
| Starting Page | 1087054717696773 |
| Ending Page | 1087054717696773 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/annonc/23/12/10.1093_annonc_mds173/2/mds173.pdf?Expires=1498633077&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q&Signature=KhTqNwxtFKAhVbIoCjxVEFw1vxbhFhteEuiVwHsCJqL~yw~qCJeTAka2XIte6uNOComawjprIOBrhQ3OoMOZ2~3tpU3tItn8rQgrLnt9Hz8TSWxBE3dGKpmZWKORMw21H8bAlDlbRh64zjOl~viMTRKBicjsSB-bAB7vcSHIeCTnfBjE1rFRECNBTt-2ytB-LdIVE4S-7cnv1R5S9-J4JM-T-X5hhz3-pYUt6CZhuUOaWx8VeooSsco2rBx3~kWUYHpEk~WI-s5YCniie0sDFxtea3QxUk4SDU-N9WPYm28K-iPApuymhnr-INoCW8k~LQEDFnjYrS6FcLVaMz8hMA__ |
| PubMed reference number | 22831982v1 |
| Alternate Webpage(s) | https://doi.org/10.1093/annonc/mds173 |
| DOI | 10.1093/annonc/mds173 |
| Journal | Annals of oncology : official journal of the European Society for Medical Oncology |
| Volume Number | 23 |
| Issue Number | 12 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Colon Carcinoma Colonic Neoplasms Confidence Intervals Eighty Nine Fever Hyperthermic Intraperitoneal Chemotherapy Neuroectodermal Tumor, Primitive Overall Survival Patients Peritoneal Carcinomatosis Pharmaceutical Adjuvants T4a Stage Finding benefit oncology field stage IV childhood Hodgkin's lymphoma |
| Content Type | Text |
| Resource Type | Article |