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01-10-2018 | Gastrointestinal Oncology

Impact of Combination Chemotherapy in Peritoneal Mesothelioma Hyperthermic Intraperitoneal Chemotherapy (HIPEC): The RENAPE Study

Authors: Brice Malgras, MD, MSc, Etienne Gayat, MD, PhD, Olivier Aoun, MD, Réa Lo Dico, MD, PhD, Clarisse Eveno, MD, PhD, Karine Pautrat, MD, Jean-Baptiste Delhorme, MD, MSc, Guillaume Passot, MD, PhD, Frédéric Marchal, MD, PhD, Olivia Sgarbura, MD, PhD, Gwenael Ferron, MD, PhD, Diane Goéré, MD, PhD, Thierry Andre, MD, PhD, Marc Pocard, MD, PhD, on behalf of the RENAPE Network

Published in: Annals of Surgical Oncology | Issue 11/2018

Abstract

Background

The introduction of cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) improved the prognosis of selected patients with peritoneal mesothelioma (PM).

Objective

The objective of our study was to evaluate whether different HIPEC agents were associated with different outcomes in patients with PM.

Methods

From the RENAPE database, we selected all patients with histology-proven PM who underwent CRS + HIPEC from 1989 to 2014. Inclusion criteria were age ≤ 80 years, performance status ≤ 2, and no extraperitoneal metastases.

Results

Overall, 249 patients underwent CRS + HIPEC for PM. The HIPEC regimen included five chemotherapeutic agents (CAs), consisting of cisplatin, doxorubicin, mitomycin-C, oxaliplatin, and irinotecan. When considering all CAs (alone or in combination), there was no significant statistical difference in regard to postoperative overall survival (OS). However, OS was better when using two CAs (group 2 drugs) versus one CA (group 1 drug) (p = 0.03). The different CA regimens were equally distributed between the two groups. This association between OS and HIPEC agent, as well as a trend for better progression-free survival, were both observed in the two-drug group versus the one-drug group (p = 0.009) for patients undergoing complete cytoreductive surgery (CC-0) with an epithelioid subtype.

Conclusions

This large study seems to show improved OS when combined CAs, especially with platinum-based regimens, are used for HIPEC in patients with PM, but needs to be confirmed by a randomized controlled trial.

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Title: Impact of Combination Chemotherapy in Peritoneal Mesothelioma Hyperthermic Intraperitoneal Chemotherapy (HIPEC): The RENAPE Study
Authors: Brice Malgras, MD, MSc
Etienne Gayat, MD, PhD
Olivier Aoun, MD
Réa Lo Dico, MD, PhD
Clarisse Eveno, MD, PhD
Karine Pautrat, MD
Jean-Baptiste Delhorme, MD, MSc
Guillaume Passot, MD, PhD
Frédéric Marchal, MD, PhD
Olivia Sgarbura, MD, PhD
Gwenael Ferron, MD, PhD
Diane Goéré, MD, PhD
Thierry Andre, MD, PhD
Marc Pocard, MD, PhD
on behalf of the RENAPE Network
Publication date: 01-10-2018
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 11/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-018-6631-2

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Impact of Combination Chemotherapy in Peritoneal Mesothelioma Hyperthermic Intraperitoneal Chemotherapy (HIPEC): The RENAPE Study

Abstract

Background

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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