Annals of surgical oncology · 2026
Secondary Cytoreductive Surgery ± Hyperthermic Intraperitoneal Chemotherapy for Recurrent Colorectal Cancer Peritoneal Metastases.
СтатьяНазвание и аннотация: Перевод в очереди
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Oppat Kailey M, Bennett Frances J, Patel Sameer H, Raoof Mustafa, Baumgartner Joel M, Mogal Harveshp D, Lambert Laura A, Abbott Daniel E, Greer Jonathan B, Grotz Travis E, Fournier Keith F, Dineen Sean P, Powers Benjamin, Zaidi Mohammad Y, Winer Joshua H, Russell Maria C, Staley Charles A, Cloyd Jordan M, Maithel Shishir K, Concors Seth J
Аннотация
BACKGROUND: Most patients who have colorectal cancer peritoneal metastases (CRC-PM) treated with cytoreductive surgery ± hyperthermic intraperitoneal chemotherapy (CRS±HIPEC) experience recurrence within 1 year. This study assessed the safety and oncologic value of secondary CRS±HIPEC for patients with CRC-PM.
METHODS: A multi-institutional database of patients treated for CRC-PM (2000-2024) was reviewed. Patients who underwent curative-intent initial CRS±HIPEC alone were compared with those who underwent secondary CRS±HIPEC for recurrent disease. Patients who received more than two procedures were excluded. The primary objective was to evaluate the safety of secondary CRS±HIPEC for CRC-PM as measured by perioperative outcomes. The secondary objective was to examine the association between overall survival (OS) and secondary CRS±HIPEC.
RESULTS: The study included 136 patients, 17 of whom underwent secondary CRS±HIPEC. There was no difference in postoperative complications between secondary and initial CRS±HIPEC. When OS was defined from the date of the index operation, secondary CRS±HIPEC was associated with improved OS versus initial CRS±HIPEC alone (51.0 months [95% confidence interval {CI}, 39.8-62.2 months] vs. 24.0 months [95 % CI, 19.4-28.6) months]). To assess the value of secondary CRS±HIPEC, OS was compared from the date of the second procedure for the secondary cohort. Overall survival measured after secondary CRS±HIPEC was similar to that after initial CRS±HIPEC (27.0 months [95 % CI, 17.3-36.7 months] vs. 24.0 months [95 % CI, 19.4-28.6 months]). Among the patients with recurrence after their index CRS±HIPEC, secondary CRS±HIPEC remained associated with better OS than that of those who received only one procedure (27.0 months [95 % CI, 17.3-36.7 months] vs. 12.0 months [95 % CI, 9.2-14.8 months]).
CONCLUSION: Secondary CRS±HIPEC should be considered for well-selected patients with CRC-PM recurrence.
METHODS: A multi-institutional database of patients treated for CRC-PM (2000-2024) was reviewed. Patients who underwent curative-intent initial CRS±HIPEC alone were compared with those who underwent secondary CRS±HIPEC for recurrent disease. Patients who received more than two procedures were excluded. The primary objective was to evaluate the safety of secondary CRS±HIPEC for CRC-PM as measured by perioperative outcomes. The secondary objective was to examine the association between overall survival (OS) and secondary CRS±HIPEC.
RESULTS: The study included 136 patients, 17 of whom underwent secondary CRS±HIPEC. There was no difference in postoperative complications between secondary and initial CRS±HIPEC. When OS was defined from the date of the index operation, secondary CRS±HIPEC was associated with improved OS versus initial CRS±HIPEC alone (51.0 months [95% confidence interval {CI}, 39.8-62.2 months] vs. 24.0 months [95 % CI, 19.4-28.6) months]). To assess the value of secondary CRS±HIPEC, OS was compared from the date of the second procedure for the secondary cohort. Overall survival measured after secondary CRS±HIPEC was similar to that after initial CRS±HIPEC (27.0 months [95 % CI, 17.3-36.7 months] vs. 24.0 months [95 % CI, 19.4-28.6 months]). Among the patients with recurrence after their index CRS±HIPEC, secondary CRS±HIPEC remained associated with better OS than that of those who received only one procedure (27.0 months [95 % CI, 17.3-36.7 months] vs. 12.0 months [95 % CI, 9.2-14.8 months]).
CONCLUSION: Secondary CRS±HIPEC should be considered for well-selected patients with CRC-PM recurrence.