Hyperthermic intraperitoneal intraoperative chemotherapy following cytoreductive surgery for the treatment of abdominal sarcomatosis: clinical outcome and prognostic factors in 60 consecutive patients
| Autor: | Michele De Simone, Mario Lise, Alessandro Gronchi, Marcello Deraco, Shigeki Kusamura, Mirto Foletto, Pierluigi Pilati, Simone Mocellin, Francesco Cavaliere, Carlo Riccardo Rossi |
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| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Risk Assessment Statistics Nonparametric Laparotomy Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies Prospective cohort study Peritoneal Neoplasms Survival analysis Aged Chemotherapy Intraoperative Care business.industry Sarcoma Multimodal therapy Hyperthermia Induced Middle Aged medicine.disease Combined Modality Therapy Survival Analysis Minimal residual disease Surgery Treatment Outcome medicine.anatomical_structure Oncology Abdominal Neoplasms Chemotherapy Cancer Regional Perfusion Multivariate Analysis Abdomen Female business Follow-Up Studies |
| Popis: | BACKGROUND Abdominal sarcomatosis is a rare nosologic entity with a poor prognosis. After a Phase I study on cytoreductive surgery combined with hyperthermic intraperitoneal intraoperative chemotherapy (HIIC), the authors reported the results of the treatment of 60 patients using this novel multimodal approach. METHODS Twenty-nine patients had multifocal primary disease and 31 patients had recurrent abdominal sarcoma. Tumor histology was represented by visceral (n = 26 [43%]) and retroperitoneal (n = 34 [57%]) sarcoma. All patients underwent cytoreductive surgery (with no or minimal residual disease) and 90-minute HIIC with doxorubicin (15.25 mg/L of perfusate) and cisplatin (43 mg/L). The clinical outcome and the prognostic value of 11 clinicopathologic variables were analyzed. RESULTS No postoperative deaths occurred. The morbidity rate was 33% and the moderate to severe locoregional toxicity rate was 15%. The median time to local disease progression and the median overall survival were 22 months and 34 months, respectively. Using multivariate analysis, histologic grading and completeness of surgical cytoreduction predicted patient prognosis, indicating that both local progression-free and overall survival were affected significantly by tumor aggressiveness and local disease control. CONCLUSIONS Although these results were encouraging, there was no definitive conclusion reached regarding the therapeutic activity of this locoregional treatment. In addition, the toxicity rate was substantial. In the absence of effective systemic agents, the therapeutic potential of cytoreductive surgery plus HIIC should be explored further in comparative trials. Cancer 2004. © 2004 American Cancer Society. |
| Databáze: | OpenAIRE |
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