MedStar Authors catalog › Details for: Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases From a Small Bowel Adenocarcinoma: Multi-Institutional Experience.
Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases From a Small Bowel Adenocarcinoma: Multi-Institutional Experience. Journal: Annals of surgical oncology.Published: 2018ISSN: 1068-9265.UI/PMID: 29484565.Subject(s): Adenocarcinoma/sc [Secondary] | *Adenocarcinoma/th [Therapy] | Adult | Aged | *Antineoplastic Combined Chemotherapy Protocols/ad [Administration & Dosage] | Cytoreduction Surgical Procedures/ae [Adverse Effects] | *Cytoreduction Surgical Procedures | Disease-Free Survival | Female | Humans | *Hyperthermia, Induced | *Intestinal Neoplasms/pa [Pathology] | Intestinal Neoplasms/th [Therapy] | Intestine, Small | Lymphatic Metastasis | Male | Middle Aged | Neoplasm Grading | Peritoneal Neoplasms/sc [Secondary] | *Peritoneal Neoplasms/th [Therapy] | Postoperative Complications/et [Etiology] | Registries | Severity of Illness Index | Survival RateInstitution(s): Washington Cancer InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1245/s10434-018-6369-x (Click here) Abbreviated citation: Ann Surg Oncol. 2018 Feb 26; Ann Surg Oncol. 25(5):1184-1192, 2018 May.Local Holdings: Available online from MWHC library: 1994 - present.Abstract: BACKGROUND: The multi-institutional registry in this study evaluated the outcome after cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal metastases (PM) from small bowel adenocarcinoma (SBA).Abstract: METHODS: A multi-institutional data registry including 152 patients with PM from SBA was established. The primary end point was overall survival (OS) after CRS plus HIPEC.Abstract: RESULTS: Between 1989 and 2016, 152 patients from 21 institutions received a treatment of CRS plus HIPEC. The median follow-up period was 20 months (range 1-100 months). Of the 152 patients, 70 (46.1%) were women with a median age of 54 years. The median peritoneal cancer index (PCI) was 10 (mean 12; range 1-33). Completeness of cytoreduction (CCR) 0 or 1 was achieved for 134 patients (88.2%). After CRS and HIPEC, the median OS was 32 months (range 1-100 months), with survival rates of 83.2% at 1 year, 46.4% at 3 years, and 30.8% at 5 years. The median disease-free survival after CCR 0/1 was 14 months (range 1-100 months). The treatment-related mortality rate was 2%, and 29 patients (19.1%) experienced grades 3 or 4 operative complications. The period between detection of PM and CRS plus HIPEC was 6 months or less (P = 0.008), and multivariate analysis identified absence of lymph node metastasis (P = 0.037), well-differentiated tumor (P = 0.028), and PCI of 15 or lower (P = 0.003) as independently associated with improved OS.Abstract: CONCLUSION: The combined treatment strategy of CRS plus HIPEC achieved prolonged survival for selected patients who had PM from SBA with acceptable morbidity and mortality.