Citations 1
Impact of Neoadjuvant Chemotherapy on the Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Peritoneal Metastases: A Multi-Institutional Retrospective Review
Suarez‐Kelly, Lorena P. , Kimbrough, Charles W. , Abbott, Daniel E. , Pokrzywa, Courtney , Raoof, Mustafa , Lee, Byrne , Grotz, Travis E. , Leiting, Jennifer L. , Dineen, Seán , Powers, Benjamin D. , Veerapong, Jula , Baumgartner, Joel , Russell, Marti C., Zaidi, M., Dhar, Vikrom K. , Lambert, Laura , Hendrix, Ryan J. , Abdel‐Misih, Sherif , Cloyd, Jordan M. , Suarez-Kelly, Lorena P , Pokrzywa, Courtney , Grotz, Travis E , Dineen, Sean P , Hendrix, Ryan J , Abdel-Misih, Sherif , Powers, Benjamin , Dhar, Vikrom , Beal, Eliza Wright , Johnston, Fabian M , Greer, Jonathan B. , Fournier, Keith F. , Lee, Andrew , Clarke, Callisia N. , Mogal, Harveshp , Zaidi, Mohammed Y., Patel, Sameer H , Hays, John L.
Journal of Clinical Medicine | March 12, 2020 | Volume: 9 | Issue: 3 | Pages: 748
Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with improved survival for patients with colorectal peritoneal metastases (CR-PM). However, the role of neoadjuvant chemotherapy (NAC) prior to CRS-HIPEC is poorly understood. A retrospective review of adult patients with CR-PM who underwent CRS+/-HIPEC from 2000–2017 was performed. Among 298 patients who underwent CRS+/-HIPEC, 196 (65.8%) received NAC while 102 (34.2%) underwent surgery first (SF). Patients who received NAC had lower peritoneal cancer index score (12.1 + 7.9 vs. 14.3 + 8.5, p = 0.034). There was no significant difference in grade III/IV complications (22.4% vs. 16.7%, p = 0.650), readmission (32.3% vs. 23.5%, p = 0.114), or 30-day mortality (1.5% vs. 2.9%, p = 0.411) between groups. NAC patients experienced longer overall survival (OS) (median 32.7 vs. 22.0 months, p = 0.044) but similar recurrence-free survival (RFS) (median 13.8 vs. 13.0 months, p = 0.456). After controlling for confounding factors, NAC was not independently associated with improved OS (OR 0.80) or RFS (OR 1.04). Among patients who underwent CRS+/-HIPEC for CR-PM, the use of NAC was associated with improved OS that did not persist on multivariable analysis. However, NAC prior to CRS+/-HIPEC was a safe and feasible strategy for CR-PM, which may aid in the appropriate selection of patients for aggressive cytoreductive surgery.