Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis in the elderly: A case-controlled, multicenter study

Autor: Alyami, Mohammad, Lundberg, Peter, Kepenekian, Vahan, Goere, Diane, Bereder, Jean-Marc, Msika, Simon, Lorimier, Gérard, Quenet, François, Ferron, Gwenaël, Thibaudeau, Emilie, Abboud, Karine, Lo Dico, Réa, Delroeux, Delphine, Brigand, Cécile, Arvieux, Catherine, Marchal , Frédéric, Tuech, Jean-Jacques, Guilloit, Jean-Marc, Guyon, Frédéric, Peyrat, Patrice, Pezet, Denis, Ortega-Deballon, Pablo, Zinzindohoué, Franck, de Chaisemartin, Cécile, Kianmanesh, Reza, Glehen, Olivier, Passot, Guillaume, Group, BIG-RENAPE, Group, RENAPE
Přispěvatelé: Service d'Oncologie Médicale [Centre hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département de chirurgie, CRLCC Val d'Aurelle - Paul Lamarque, Institut Claudius Regaud, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, CHU Saint-Etienne, Service de Chirurgie d'Oncologie Digestive [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital de Hautepierre [Strasbourg], CHU Grenoble, Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), Service de chirurgie digestive [CHU Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Centre Léon Bérard [Lyon], CHU Clermont-Ferrand, Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de chirurgie digestive, générale et cancérologique [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre Hospitalier Universitaire de Reims (CHU Reims), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
MESH: Combined Modality Therapy
Health Status
030230 surgery
MESH: Cause of Death
0302 clinical medicine
MESH: Aged
80 and over
Cause of Death
Antineoplastic Combined Chemotherapy Protocols
MESH: Peritoneal Neoplasms
Young adult
Peritoneal Neoplasms
MESH: Health Status
Cause of death
Aged
80 and over
MESH: Aged
MESH: Middle Aged
Age Factors
Cytoreduction Surgical Procedures
Middle Aged
Combined Modality Therapy
MESH: Case-Control Studies
3. Good health
MESH: Antineoplastic Combined Chemotherapy Protocols
Oncology
Failure to Rescue
Health Care
Cardiovascular Diseases
MESH: Young Adult
030220 oncology & carcinogenesis
Cohort
Hyperthermic intraperitoneal chemotherapy
Female
Adult
medicine.medical_specialty
Adolescent
MESH: Failure to Rescue
Health Care
[SDV.CAN]Life Sciences [q-bio]/Cancer
03 medical and health sciences
Young Adult
medicine
Humans
MESH: Cytoreduction Surgical Procedures
MESH: Hyperthermia
Induced
Aged
Retrospective Studies
MESH: Adolescent
MESH: Age Factors
MESH: Humans
business.industry
Case-control study
MESH: Cardiovascular Diseases
Retrospective cohort study
MESH: Adult
MESH: Retrospective Studies
Hyperthermia
Induced
MESH: Male
Surgery
Case-Control Studies
Conventional PCI
Peritoneal Cancer Index
business
MESH: Female
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: Annals of Surgical Oncology
Annals of Surgical Oncology, Springer Verlag, 2016, 23 (S5), pp.737-745. ⟨10.1245/s10434-016-5519-2⟩
ISSN: 1068-9265
1534-4681
DOI: 10.1245/s10434-016-5519-2⟩
Popis: International audience; OBJECTIVE:This study was designed to identify factors associated with morbidity and mortality in patients older than 70 years who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis (PC).BACKGROUND:Major surgery is associated with higher morbidity and mortality in elderly patients. For PC, CRS and HIPEC is the only current potential curative therapy, but the risks inherent to this patient population have called its benefits into question.METHODS:We retrospectively analyzed a multi-center database from 1989 to 2015. All patients who underwent CRS and HIPEC for PC were selected and patients older than 70 years were matched 1:4 with a younger cohort according to cancer origin, peritoneal cancer index (PCI), and completeness of cytoreduction. Major morbidity and mortality were analyzed.RESULTS:Of 2328 patients, 188 patients older than aged 70 years were matched with 704 younger patients. Patients older than aged 70 years demonstrated a higher American Society of Anesthesiologist score (≥ASA III 10.8 vs. 6.6 %, p = 0.008). There was no difference in overall 90-day morbidity (≥70: 45.7 % vs. 7 (95 % CI 1.051-5.798, p = 0.038) and HIPEC duration (95 % CI 1.106-6.235, p = 0.028) were independent factors associated with morbidity in elderly patients.CONCLUSIONS:CRS and HIPEC appear feasible for selected patients older than aged 70 years, albeit with a higher risk of medical complications associated with increased mortality.
Databáze: OpenAIRE
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