Cytoreductive surgery and hyperthermic intraperitoneal perfusion with chemotherapy in children with peritoneal tumor spread: A French nationwide study over 14 years
| Autor: | Nadège Corradini, Laurence Brugières, Denis Pezet, Daniel Orbach, François Becmeur, Marc-David Leclair, Cécile Brigand, Simon Msika, Guillaume Passot, Aurélien Scalabre, Dominique Elias, Johan Gagnière, Pascale Philippe-Chomette, Solène Joseph, Christine Soler, Sabine Sarnacki, Olivier Glehen |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Mesothelioma medicine.medical_specialty Desmoplastic small-round-cell tumor Adolescent medicine.medical_treatment Disease-Free Survival 03 medical and health sciences Peritoneal Neoplasm 0302 clinical medicine Pancreatic tumor Laparotomy medicine Humans Child Survival rate Peritoneal Neoplasms Retrospective Studies business.industry Multimodal therapy Hematology Cytoreduction Surgical Procedures Hyperthermia Induced medicine.disease Surgery Survival Rate Oncology 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Peritoneal mesothelioma 030211 gastroenterology & hepatology Female France business Follow-Up Studies |
| Zdroj: | Pediatric bloodcancer. 65(4) |
| ISSN: | 1545-5017 |
| Popis: | Background Efficacy and role of cytoreductive surgery (CRS) and hyperthermic peritoneal perfusion with chemotherapy (HIPEC) remain poorly documented in pediatric tumors. Methods This retrospective national study analyzed all pediatric patients with peritoneal tumor spread treated by CRS and HIPEC as part of a multimodal therapy in France from 2001 to 2015. Results Twenty-two patients (nine males and 13 females) were selected. The median age at diagnosis was 14.8 years (4.2-17.6). Seven had peritoneal mesotheliomas; seven, desmoplastic small round cells tumors (DSRCT); and eight, other histologic types. A complete macroscopic resection (CC-0, where CC is completeness of cytoreduction) was achieved in 16 (73%) cases. Incomplete resections were classified as CC-1 in four (18%) cases and CC-2 in two (9%) cases. Fourteen (64%) patients had complications within 30 days from HIPEC, requiring an urgent laparotomy in eight (36%) cases. Thirteen (59%) patients received adjuvant chemotherapy and four (18%) received total abdominal radiotherapy after surgery. Sixteen (72%) patients had relapse after a median time of 9.6 months (1.4-86.4) and nine (41%) eventually died after a median time of 5.3 months (0.1-36.1) from relapse. Six (27%) patients (four mesotheliomas, one pseudopapillary pancreatic tumor, and one DSRCT) were alive and in complete remission after a median follow-up of 25.0 months (5.3-78.2). The mean overall survival (OS) and disease-free survival (DFS) were 57.5 months (95% CI [38.59-76.32]) and 30.9 months (95% CI [14.96-46.77]). Patients with a peritoneal mesothelioma had a significantly better OS (p = 0.015) and DFS (p = 0.028) than other histologic type. Conclusions In this national series, outcomes of HIPEC are encouraging for the treatment of peritoneal mesothelioma in children. |
| Databáze: | OpenAIRE |
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