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A total neoadjuvant chemotherapy approach is associated with improved recurrence‐free survival in patients with colorectal peritoneal metastases undergoing cytoreductive surgery and HIPEC

Title: A total neoadjuvant chemotherapy approach is associated with improved recurrence‐free survival in patients with colorectal peritoneal metastases undergoing cytoreductive surgery and HIPEC
Authors: Hanna, David N.; Macfie, Rebekah; Ghani, Muhammad O.; Hermina, Andrew; Mina, Alexander; Cha, Da Eun; Bailey, Christina E.; Cohen, Noah; Labow, Daniel; Golas, Benjamin; Sarpel, Umut; Magge, Deepa; Idrees, Kamran
Contributors: National Cancer Institute
Source: Journal of Surgical Oncology ; volume 127, issue 3, page 442-449 ; ISSN 0022-4790 1096-9098
Publisher Information: Wiley
Publication Year: 2022
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Background The primary aim of this study is to evaluate the oncologic outcomes of two popular systemic chemotherapy approaches in patients with colorectal peritoneal metastases (CPM) undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS‐HIPEC). Methods We performed a dual‐center retrospective review of consecutive patients who underwent CRS‐HIPEC for CPM due to high or intermediate‐grade colorectal cancer. Patients in the total neoadjuvant therapy (TNT) group received 6 months of preoperative chemotherapy. Patients in the “sandwich” (SAND) chemotherapy group received 3 months of preoperative chemotherapy with a maximum of 3 months of postoperative chemotherapy. Results A total of 34 (43%) patients were included in the TNT group and 45 (57%) patients in the SAND group. The median overall survival (OS) in the TNT and SAND groups were 77 and 61 months, respectively ( p = 0.8). Patients in the TNT group had significantly longer recurrence‐free survival (RFS) than the SAND group (29 vs. 12 months, p = 0.02). In a multivariable analysis, the TNT approach was independently associated with improved RFS. Conclusion In this retrospective study, a TNT approach was associated with improved RFS, but not OS when compared with a SAND approach. Further prospective studies are needed to examine these systemic chemotherapeutic approaches in patients with CPM undergoing CRS‐HIPEC.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1002/jso.27136
Availability: https://doi.org/10.1002/jso.27136; https://onlinelibrary.wiley.com/doi/pdf/10.1002/jso.27136; https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jso.27136
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.60E83C76
Database: BASE