Primary Tumor Sidedness is Predictive of Survival in Colon Cancer Patients Treated with Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy: A US HIPEC Collaborative Study

Nikhil V. Kotha, Joel M. Baumgartner, Jula Veerapong, Jordan M. Cloyd, Ahmed Ahmed, Travis E. Grotz, Jennifer L. Leiting, Keith Fournier, Andrew J. Lee, Sean P. Dineen, Sophie Dessureault, Callisia Clarke, Harveshp Mogal, Mohammad Y. Zaidi, Maria C. Russell, Sameer H. Patel, Jeffrey J. Sussman, Vikrom Dhar, Laura A. Lambert, Ryan J. HendrixDaniel E. Abbott, Courtney Pokrzywa, Kelly Lafaro, Byrne Lee, Jonathan B. Greer, Nadege Fackche, Andrew M. Lowy, Kaitlyn J. Kelly

Research output: Contribution to journalArticle

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Abstract

Introduction: The clinical relevance of primary tumor sidedness is not fully understood in colon cancer patients with peritoneal metastasis treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: This was a retrospective cohort study of a multi-institutional database of patients with peritoneal surface malignancy at 12 participating high-volume academic centers from the US HIPEC Collaborative. Results: Overall, 336 patients with colon primary tumors who underwent curative-intent CRS with or without HIPEC were identified; 179 (53.3%) patients had right-sided primary tumors and 157 (46.7%) had left-sided primary tumors. Patients with right-sided tumors were more likely to be older, male, have higher Peritoneal Cancer Index (PCI), and have a perforated primary tumor, but were less likely to have extraperitoneal disease. Patients with complete cytoreduction (CC-0/1) had a median disease-free survival (DFS) of 11.5 months (95% confidence interval [CI] 7.6–15.3) versus 13.1 months (95% CI 9.5–16.8) [p = 0.158] and median overall survival (OS) of 30 months (95% CI 23.5–36.6) versus 45.4 months (95% CI 35.9–54.8) [p = 0.028] for right- and left-sided tumors; respectively. Multivariate analysis revealed that right-sided primary tumor was an independent predictor of worse DFS (hazard ratio [HR] 1.75, 95% CI 1.19–2.56; p =0.004) and OS (HR 1.72, 95% CI 1.09–2.73; p = 0.020). Conclusion: Right-sided primary tumor was an independent predictor of worse DFS and OS. Relevant clinicopathologic criteria, such as tumor sidedness and PCI, should be considered in patient selection for CRS with or without HIPEC, and guide stratification for clinical trials.

Original languageEnglish (US)
Pages (from-to)2234-2240
Number of pages7
JournalAnnals of surgical oncology
Volume26
Issue number7
DOIs
StatePublished - Jul 15 2019

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Colonic Neoplasms
Drug Therapy
Survival
Neoplasms
Confidence Intervals
Disease-Free Survival
Patient Rights
Patient Selection
Colon
Cohort Studies
Multivariate Analysis
Retrospective Studies
Clinical Trials
Databases
Neoplasm Metastasis

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Primary Tumor Sidedness is Predictive of Survival in Colon Cancer Patients Treated with Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy : A US HIPEC Collaborative Study. / Kotha, Nikhil V.; Baumgartner, Joel M.; Veerapong, Jula; Cloyd, Jordan M.; Ahmed, Ahmed; Grotz, Travis E.; Leiting, Jennifer L.; Fournier, Keith; Lee, Andrew J.; Dineen, Sean P.; Dessureault, Sophie; Clarke, Callisia; Mogal, Harveshp; Zaidi, Mohammad Y.; Russell, Maria C.; Patel, Sameer H.; Sussman, Jeffrey J.; Dhar, Vikrom; Lambert, Laura A.; Hendrix, Ryan J.; Abbott, Daniel E.; Pokrzywa, Courtney; Lafaro, Kelly; Lee, Byrne; Greer, Jonathan B.; Fackche, Nadege; Lowy, Andrew M.; Kelly, Kaitlyn J.

In: Annals of surgical oncology, Vol. 26, No. 7, 15.07.2019, p. 2234-2240.

Research output: Contribution to journalArticle

Kotha, NV, Baumgartner, JM, Veerapong, J, Cloyd, JM, Ahmed, A, Grotz, TE, Leiting, JL, Fournier, K, Lee, AJ, Dineen, SP, Dessureault, S, Clarke, C, Mogal, H, Zaidi, MY, Russell, MC, Patel, SH, Sussman, JJ, Dhar, V, Lambert, LA, Hendrix, RJ, Abbott, DE, Pokrzywa, C, Lafaro, K, Lee, B, Greer, JB, Fackche, N, Lowy, AM & Kelly, KJ 2019, 'Primary Tumor Sidedness is Predictive of Survival in Colon Cancer Patients Treated with Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy: A US HIPEC Collaborative Study', Annals of surgical oncology, vol. 26, no. 7, pp. 2234-2240. https://doi.org/10.1245/s10434-019-07373-0
Kotha, Nikhil V. ; Baumgartner, Joel M. ; Veerapong, Jula ; Cloyd, Jordan M. ; Ahmed, Ahmed ; Grotz, Travis E. ; Leiting, Jennifer L. ; Fournier, Keith ; Lee, Andrew J. ; Dineen, Sean P. ; Dessureault, Sophie ; Clarke, Callisia ; Mogal, Harveshp ; Zaidi, Mohammad Y. ; Russell, Maria C. ; Patel, Sameer H. ; Sussman, Jeffrey J. ; Dhar, Vikrom ; Lambert, Laura A. ; Hendrix, Ryan J. ; Abbott, Daniel E. ; Pokrzywa, Courtney ; Lafaro, Kelly ; Lee, Byrne ; Greer, Jonathan B. ; Fackche, Nadege ; Lowy, Andrew M. ; Kelly, Kaitlyn J. / Primary Tumor Sidedness is Predictive of Survival in Colon Cancer Patients Treated with Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy : A US HIPEC Collaborative Study. In: Annals of surgical oncology. 2019 ; Vol. 26, No. 7. pp. 2234-2240.
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title = "Primary Tumor Sidedness is Predictive of Survival in Colon Cancer Patients Treated with Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy: A US HIPEC Collaborative Study",
abstract = "Introduction: The clinical relevance of primary tumor sidedness is not fully understood in colon cancer patients with peritoneal metastasis treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: This was a retrospective cohort study of a multi-institutional database of patients with peritoneal surface malignancy at 12 participating high-volume academic centers from the US HIPEC Collaborative. Results: Overall, 336 patients with colon primary tumors who underwent curative-intent CRS with or without HIPEC were identified; 179 (53.3{\%}) patients had right-sided primary tumors and 157 (46.7{\%}) had left-sided primary tumors. Patients with right-sided tumors were more likely to be older, male, have higher Peritoneal Cancer Index (PCI), and have a perforated primary tumor, but were less likely to have extraperitoneal disease. Patients with complete cytoreduction (CC-0/1) had a median disease-free survival (DFS) of 11.5 months (95{\%} confidence interval [CI] 7.6–15.3) versus 13.1 months (95{\%} CI 9.5–16.8) [p = 0.158] and median overall survival (OS) of 30 months (95{\%} CI 23.5–36.6) versus 45.4 months (95{\%} CI 35.9–54.8) [p = 0.028] for right- and left-sided tumors; respectively. Multivariate analysis revealed that right-sided primary tumor was an independent predictor of worse DFS (hazard ratio [HR] 1.75, 95{\%} CI 1.19–2.56; p =0.004) and OS (HR 1.72, 95{\%} CI 1.09–2.73; p = 0.020). Conclusion: Right-sided primary tumor was an independent predictor of worse DFS and OS. Relevant clinicopathologic criteria, such as tumor sidedness and PCI, should be considered in patient selection for CRS with or without HIPEC, and guide stratification for clinical trials.",
author = "Kotha, {Nikhil V.} and Baumgartner, {Joel M.} and Jula Veerapong and Cloyd, {Jordan M.} and Ahmed Ahmed and Grotz, {Travis E.} and Leiting, {Jennifer L.} and Keith Fournier and Lee, {Andrew J.} and Dineen, {Sean P.} and Sophie Dessureault and Callisia Clarke and Harveshp Mogal and Zaidi, {Mohammad Y.} and Russell, {Maria C.} and Patel, {Sameer H.} and Sussman, {Jeffrey J.} and Vikrom Dhar and Lambert, {Laura A.} and Hendrix, {Ryan J.} and Abbott, {Daniel E.} and Courtney Pokrzywa and Kelly Lafaro and Byrne Lee and Greer, {Jonathan B.} and Nadege Fackche and Lowy, {Andrew M.} and Kelly, {Kaitlyn J.}",
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day = "15",
doi = "10.1245/s10434-019-07373-0",
language = "English (US)",
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TY - JOUR

T1 - Primary Tumor Sidedness is Predictive of Survival in Colon Cancer Patients Treated with Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy

T2 - A US HIPEC Collaborative Study

AU - Kotha, Nikhil V.

AU - Baumgartner, Joel M.

AU - Veerapong, Jula

AU - Cloyd, Jordan M.

AU - Ahmed, Ahmed

AU - Grotz, Travis E.

AU - Leiting, Jennifer L.

AU - Fournier, Keith

AU - Lee, Andrew J.

AU - Dineen, Sean P.

AU - Dessureault, Sophie

AU - Clarke, Callisia

AU - Mogal, Harveshp

AU - Zaidi, Mohammad Y.

AU - Russell, Maria C.

AU - Patel, Sameer H.

AU - Sussman, Jeffrey J.

AU - Dhar, Vikrom

AU - Lambert, Laura A.

AU - Hendrix, Ryan J.

AU - Abbott, Daniel E.

AU - Pokrzywa, Courtney

AU - Lafaro, Kelly

AU - Lee, Byrne

AU - Greer, Jonathan B.

AU - Fackche, Nadege

AU - Lowy, Andrew M.

AU - Kelly, Kaitlyn J.

PY - 2019/7/15

Y1 - 2019/7/15

N2 - Introduction: The clinical relevance of primary tumor sidedness is not fully understood in colon cancer patients with peritoneal metastasis treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: This was a retrospective cohort study of a multi-institutional database of patients with peritoneal surface malignancy at 12 participating high-volume academic centers from the US HIPEC Collaborative. Results: Overall, 336 patients with colon primary tumors who underwent curative-intent CRS with or without HIPEC were identified; 179 (53.3%) patients had right-sided primary tumors and 157 (46.7%) had left-sided primary tumors. Patients with right-sided tumors were more likely to be older, male, have higher Peritoneal Cancer Index (PCI), and have a perforated primary tumor, but were less likely to have extraperitoneal disease. Patients with complete cytoreduction (CC-0/1) had a median disease-free survival (DFS) of 11.5 months (95% confidence interval [CI] 7.6–15.3) versus 13.1 months (95% CI 9.5–16.8) [p = 0.158] and median overall survival (OS) of 30 months (95% CI 23.5–36.6) versus 45.4 months (95% CI 35.9–54.8) [p = 0.028] for right- and left-sided tumors; respectively. Multivariate analysis revealed that right-sided primary tumor was an independent predictor of worse DFS (hazard ratio [HR] 1.75, 95% CI 1.19–2.56; p =0.004) and OS (HR 1.72, 95% CI 1.09–2.73; p = 0.020). Conclusion: Right-sided primary tumor was an independent predictor of worse DFS and OS. Relevant clinicopathologic criteria, such as tumor sidedness and PCI, should be considered in patient selection for CRS with or without HIPEC, and guide stratification for clinical trials.

AB - Introduction: The clinical relevance of primary tumor sidedness is not fully understood in colon cancer patients with peritoneal metastasis treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: This was a retrospective cohort study of a multi-institutional database of patients with peritoneal surface malignancy at 12 participating high-volume academic centers from the US HIPEC Collaborative. Results: Overall, 336 patients with colon primary tumors who underwent curative-intent CRS with or without HIPEC were identified; 179 (53.3%) patients had right-sided primary tumors and 157 (46.7%) had left-sided primary tumors. Patients with right-sided tumors were more likely to be older, male, have higher Peritoneal Cancer Index (PCI), and have a perforated primary tumor, but were less likely to have extraperitoneal disease. Patients with complete cytoreduction (CC-0/1) had a median disease-free survival (DFS) of 11.5 months (95% confidence interval [CI] 7.6–15.3) versus 13.1 months (95% CI 9.5–16.8) [p = 0.158] and median overall survival (OS) of 30 months (95% CI 23.5–36.6) versus 45.4 months (95% CI 35.9–54.8) [p = 0.028] for right- and left-sided tumors; respectively. Multivariate analysis revealed that right-sided primary tumor was an independent predictor of worse DFS (hazard ratio [HR] 1.75, 95% CI 1.19–2.56; p =0.004) and OS (HR 1.72, 95% CI 1.09–2.73; p = 0.020). Conclusion: Right-sided primary tumor was an independent predictor of worse DFS and OS. Relevant clinicopathologic criteria, such as tumor sidedness and PCI, should be considered in patient selection for CRS with or without HIPEC, and guide stratification for clinical trials.

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U2 - 10.1245/s10434-019-07373-0

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