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Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan

Authors
 Daichi Kitaguchi  ;  Eun Jung Park  ;  Seung Hyuk Baik  ;  Shoma Sasaki  ;  Yuichiro Tsukada  ;  Masaaki Ito 
Citation
 INTERNATIONAL JOURNAL OF SURGERY, Vol.110(1) : 45-52, 2024-01 
Journal Title
INTERNATIONAL JOURNAL OF SURGERY
ISSN
 1743-9191 
Issue Date
2024-01
MeSH
Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Colorectal Neoplasms* / pathology ; Combined Modality Therapy ; Cytoreduction Surgical Procedures / adverse effects ; Humans ; Hyperthermia, Induced* ; Hyperthermic Intraperitoneal Chemotherapy ; Japan ; Neoplasm Recurrence, Local / pathology ; Peritoneal Neoplasms* / drug therapy ; Peritoneal Neoplasms* / surgery ; Postoperative Complications / drug therapy ; Republic of Korea ; Retrospective Studies ; Survival Rate
Abstract
Background: The benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) for colorectal cancer with peritoneal metastasis (CPM) remain controversial. R0 resection without peritoneal stripping might be as effective as CRS plus HIPEC. The authors aimed to compare the long-term oncological outcomes of patients with CPM and peritoneal cancer index (PCI) scores less than or equal to 6 who underwent R0 resection in Japan with those who underwent CRS plus HIPEC in Korea.Materials and methods: This international, retrospective cohort study was conducted in Korea and Japan using a prospectively collected clinical database. Patients who underwent surgery from July 2014 to December 2021 for CPM with a PCI score of less than or equal to 6 and completeness of the cytoreduction score-0 were included. The primary outcome was relapse-free survival (RFS), and the secondary outcomes were overall survival, peritoneal RFS (PRFS), and postoperative outcomes.Results: The 3-year RFS was significantly longer in the CRS+HIPEC group than in the R0 resection group: 35.9% versus 6.9% (P<0.001); 31.0% versus 6.7% (P=0.040) after propensity score matching. The median PRFS was significantly longer in the CRS+HIPEC group than in the R0 resection group: 24.5 months versus 17.2 months (P=0.017). The 3-year overall survival and postoperative complications did not significantly differ between the two groups.Conclusions: RFS and PRFS rates were significantly prolonged after CRS plus HIPEC, whereas postoperative complications and length of hospital stay were not increased. Therefore, curative CRS plus HIPEC may be considered a treatment strategy for selected patients with resectable CPM and low PCI scores.
Files in This Item:
T202401554.pdf Download
DOI
10.1097/JS9.0000000000000809
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198716
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