Long-term survival after hyperthermic intraperitoneal chemotherapy using mitomycin C or oxaliplatin in colorectal cancer patients with synchronous peritoneal metastases: A nationwide comparative study

C. Bakkers*, F.N. van Erning, K.P. Rovers, S.W. Nienhuijs, J.W. Burger, V.E. Lemmens, A.G. Aalbers, N.F. Kok, D. Boerma, A.R. Brandt, P.H. Hemmer, W.M. van Grevenstein, P.R. de Reuver, P.J. Tanis, J.B. Tuynman, I.H. de Hingh

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Web of Science)

Abstract

Objectives: In the Netherlands, limited variability exists in performance of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among centers treating colorectal peritoneal metastases (PM), except for the intraperitoneal drug administration. This offers a unique opportunity to investigate any disparities in survival between the two most frequently used HIPEC regimens worldwide: mitomycin C (MMC) and oxaliplatin.Methods: This was a comparative, population-based cohort study of all Dutch patients diagnosed with synchronous colorectal PM who underwent CRS-HIPEC between 2014 and 2017. They were retrieved from the Netherlands Cancer Registry. Main outcome was overall survival (OS). The effect of the intraperitoneal drug on OS was investigated using multivariable Cox regression analysis.Results: In total, 297 patients treated between 2014 and 2017 were included. Among them, 177 (59.6%) received MMC and 120 (40.4%) received oxaliplatin. Only primary tumor location was different between the two groups: more left-sided colon in the Oxaliplatin group (47.5% vs. 33.3%, respectively, p=0.048). The 1-, 2- and 3-year OS were 84.6% vs. 85.8%, 61.6% vs. 63.9% and 44.7% vs. 53.5% in patients treated with MMC and oxaliplatin, respectively. Median OS was 30.7 months in the MMC group vs. 46.6 months in the oxaliplatin group (p=0.181). In multivariable analysis, no influence of intraperitoneal drug on survival was observed (adjusted HR 0.77 [0.53-1.13]).Conclusions: Long-term survival between patients treated with either MMC or oxaliplatin during CRS-HIPEC was not significantly different. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Original languageEnglish
Pages (from-to)1902-1907
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume46
Issue number10
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • carcinomatosis
  • colon cancer
  • cytoreductive surgery
  • hipec
  • management
  • mitomycin c
  • origin
  • oxaliplatin
  • peritoneal metastases
  • risk
  • surface malignancies
  • survival
  • CYTOREDUCTIVE SURGERY
  • ORIGIN
  • Oxaliplatin
  • Colon cancer
  • HIPEC
  • CARCINOMATOSIS
  • Mitomycin C
  • MANAGEMENT
  • Cytoreductive surgery
  • RISK
  • Survival
  • SURFACE MALIGNANCIES
  • Peritoneal metastases

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