Title :

Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastases (CYTO-CHIP study): A propensity score analysis

Author(s) :

Bonnot, Pierre-Emmanuel [Auteur]
Ciblage thérapeutique en Oncologie [EA3738]
Université Claude Bernard Lyon 1 [UCBL]
Piessen, Guillaume [Auteur]
Hôpital Claude Huriez [Lille]
Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Kepenekian, Vahan [Auteur]
Ciblage thérapeutique en Oncologie [EA3738]
Decullier, Evelyne [Auteur]
Pôle Information Médicale Evaluation Recherche [IMER]
Pocard, Marc [Auteur]
Carcinose Angiogenèse et Recherche Translationnelle ; Angiogenese et recherche translationnelle [CART U965]
Hôpital Lariboisière-Fernand-Widal [APHP]
Meunier, Bernard [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Bereder, Jean-Marc [Auteur]
Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] [UNICANCER/CAL]
Abboud, Karine [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Marchal, Frédéric [Auteur]
Centre de Recherche en Automatique de Nancy [CRAN]
Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] [UNICANCER/ICL]
Quenet, François [Auteur]
Département de chirurgie
Institut de Recherche en Cancérologie de Montpellier [IRCM - U1194 Inserm - UM]
Goere, Diane [Auteur]
Département de chirurgie générale [Gustave Roussy]
Msika, Simon [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Arvieux, Catherine [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Pirro, Nicolas [Auteur]
Hôpital Sainte-Marguerite [CHU - APHM] [Hôpitaux Sud ]
Wernert, Romuald [Auteur]
Institut de Cancérologie de l'Ouest [Angers/Nantes] [UNICANCER/ICO]
Rat, Patrick [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Gagnière, Johan [Auteur]
CHU Clermont-Ferrand
Lefevre, Jeremie [Auteur]
Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier [ICGM]
Courvoisier, Thomas [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Kianmanesh, Reza [Auteur]
Hôpital universitaire Robert Debré [Reims] [CHU Reims]
Vaudoyer, Delphine [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Rivoire, Michel [Auteur]
Centre Léon Bérard [Lyon]
Meeus, Pierre [Auteur]
Centre Léon Bérard [Lyon]
Passot, Guillaume [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Glehen, Olivier [Auteur correspondant]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]

Journal title :

Journal of Clinical Oncology

Pages :

2028-2040

Publisher :

American Society of Clinical Oncology

Publication date :

2019-08-10

ISSN :

0732-183X

HAL domain(s) :

Sciences du Vivant [q-bio]/Cancer

English abstract : [en]

PURPOSE Gastric cancer (GC) with peritoneal metastases (PMs) is a poor prognostic evolution. Cytoreductive surgery (CRS) yields promising results, but the impact of hyperthermic intraperitoneal chemotherapy (HIPEC) remains ...
Show more >PURPOSE Gastric cancer (GC) with peritoneal metastases (PMs) is a poor prognostic evolution. Cytoreductive surgery (CRS) yields promising results, but the impact of hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. Here we aimed to compare outcomes between CRS-HIPEC versus CRS alone (CRSa) among patients with PMs from GC. PATIENTS AND METHODS From prospective databases, we identified 277 patients with PMs from GC who were treated with complete CRS with curative intent (no residual nodules > 2.5 mm) at 19 French centers from 1989 to 2014. Of these patients, 180 underwent CRS-HIPEC and 97 CRSa. Tumor burden was assessed using the peritoneal cancer index. A Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW) based on propensity score was used to assess the effect of HIPEC and account for confounding factors. RESULTS After IPTW adjustment, the groups were similar, except that median peritoneal cancer index remained higher in the CRS-HIPEC group (6 v 2; P = .003). CRS-HIPEC improved overall survival (OS) in both crude and IPTW models. Upon IPTW analysis, in CRS-HIPEC and CRSa groups, median OS was 18.8 versus 12.1 months, 3- and 5-year OS rates were 26.21% and 19.87% versus 10.82% and 6.43% (adjusted hazard ratio, 0.60; 95% CI, 0.42 to 0.86; P = .005), and 3- and 5-year recurrence-free survival rates were 20.40% and 17.05% versus 5.87% and 3.76% ( P = .001), respectively; the groups did not differ regarding 90-day mortality (7.4% v 10.1%, respectively; P = .820) or major complication rate (53.7% v 55.3%, respectively; P = .496). CONCLUSION Compared with CRSa, CRS-HIPEC improved OS and recurrence-free survival, without additional morbidity or mortality. When complete CRS is possible, CRS-HIPEC may be considered a valuable therapy for strictly selected patients with limited PMs from GC.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL