TY - JOUR
T1 - Conditional Survival Following Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
T2 - An Analysis from the US HIPEC Collaborative
AU - Beal, Eliza W.
AU - Srinivas, Shruthi
AU - Shen, Chengli
AU - Kim, Alex
AU - Johnston, Fabian M.
AU - Greer, Jonathan
AU - Abbott, Daniel E.
AU - Pokrzywa, Courtney
AU - Raoof, Mustafa
AU - Grotz, Travis E.
AU - Leiting, Jennifer L.
AU - Fournier, Keith
AU - Dineen, Sean
AU - Powers, Benjamin
AU - Veerapong, Jula
AU - Kothari, Anai
AU - Maduekew, Ugwuji
AU - Maithel, Shishir
AU - Wilson, Gregory C.
AU - Patel, Sameer H.
AU - Lambert, Laura
AU - Abdel-Misih, Sherif
AU - Cloyd, Jordan M.
N1 - Funding Information:
This work was supported by National Natural Science Foundation of China (81772022), the Science and Technology Commission of Shanghai Municipality (15DZ1207500), Shanghai Key Laboratory of Forensic Medicine (21DZ2270800) and Shanghai Forensic Service Platform (19DZ2292700).
Publisher Copyright:
© 2022, Society of Surgical Oncology.
PY - 2023/3
Y1 - 2023/3
N2 - Introduction: The long-term prognosis of patients who undergo cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies (PSM) varies considerably on the basis of histological and operative factors. While overall survival (OS) estimates are used to inform adjuvant therapy and surveillance strategies, conditional survival may provide more clinically relevant estimates of prognosis by accounting for disease-free time elapsed. Patients and Methods: All patients from 12 academic institutions who underwent CRS ± HIPEC for PSM from 2000 to 2017 were retrospectively analyzed. OS and disease-free survival (DFS) rates were calculated using the Kaplan–Meier method while conditional overall (COS) and conditional disease-free survival (CDFS) rates were calculated at 1, 2, or 3 years from surgery for different tumor histologies. Results: Overall, 1610 patients underwent CRS ± HIPEC. Among patients with benign appendiceal mucinous tumors (N = 460), 5-year OS and COS at 3 years were 92.1% and 96.3% (Δ4.2%), respectively. For patients with well-differentiated appendiceal cancers (N = 400), 5-year OS and COS at 3 years were 76.3% and 88.3% (Δ12.0%), respectively. For patients with high-grade appendiceal cancers (N = 258), 5-year OS and COS at 3 years were 43.8% and 75.4% (Δ31.6%), respectively. For patients with colorectal cancers (N = 362), 5-year OS and COS at 3 years were 31.8% and 67.3% (Δ35.5%), respectively. For patients with peritoneal mesothelioma (N = 130), 5-year OS and COS at 3 years were 67.6% and 89.7% (Δ22.1%), respectively. Similar trends were observed for DFS/CDFS. Conclusion: The conditional survival of patients undergoing CRS ± HIPEC for PSM is associated with tumor histology. COS and CDFS provide a more accurate, dynamic estimate of survival than OS and DFS, especially for patients with more aggressive histologies.
AB - Introduction: The long-term prognosis of patients who undergo cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies (PSM) varies considerably on the basis of histological and operative factors. While overall survival (OS) estimates are used to inform adjuvant therapy and surveillance strategies, conditional survival may provide more clinically relevant estimates of prognosis by accounting for disease-free time elapsed. Patients and Methods: All patients from 12 academic institutions who underwent CRS ± HIPEC for PSM from 2000 to 2017 were retrospectively analyzed. OS and disease-free survival (DFS) rates were calculated using the Kaplan–Meier method while conditional overall (COS) and conditional disease-free survival (CDFS) rates were calculated at 1, 2, or 3 years from surgery for different tumor histologies. Results: Overall, 1610 patients underwent CRS ± HIPEC. Among patients with benign appendiceal mucinous tumors (N = 460), 5-year OS and COS at 3 years were 92.1% and 96.3% (Δ4.2%), respectively. For patients with well-differentiated appendiceal cancers (N = 400), 5-year OS and COS at 3 years were 76.3% and 88.3% (Δ12.0%), respectively. For patients with high-grade appendiceal cancers (N = 258), 5-year OS and COS at 3 years were 43.8% and 75.4% (Δ31.6%), respectively. For patients with colorectal cancers (N = 362), 5-year OS and COS at 3 years were 31.8% and 67.3% (Δ35.5%), respectively. For patients with peritoneal mesothelioma (N = 130), 5-year OS and COS at 3 years were 67.6% and 89.7% (Δ22.1%), respectively. Similar trends were observed for DFS/CDFS. Conclusion: The conditional survival of patients undergoing CRS ± HIPEC for PSM is associated with tumor histology. COS and CDFS provide a more accurate, dynamic estimate of survival than OS and DFS, especially for patients with more aggressive histologies.
UR - http://www.scopus.com/inward/record.url?scp=85140992327&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85140992327&partnerID=8YFLogxK
U2 - 10.1245/s10434-022-12753-0
DO - 10.1245/s10434-022-12753-0
M3 - Article
C2 - 36310315
AN - SCOPUS:85140992327
SN - 1068-9265
VL - 30
SP - 1840
EP - 1849
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 3
ER -