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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2019

01-07-2019 | Colon Cancer | Gastrointestinal Oncology

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

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

Published in: Annals of Surgical Oncology | Issue 7/2019

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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.
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Metadata
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
Authors
Nikhil V. Kotha
Joel M. Baumgartner, MD, MAS
Jula Veerapong, MD
Jordan M. Cloyd, MD
Ahmed Ahmed, MD
Travis E. Grotz, MD
Jennifer L. Leiting, MD
Keith Fournier, MD
Andrew J. Lee, MD
Sean P. Dineen, MD
Sophie Dessureault, MD, PhD
Callisia Clarke, MD
Harveshp Mogal, MD
Mohammad Y. Zaidi, MD
Maria C. Russell
Sameer H. Patel, MD
Jeffrey J. Sussman, MD
Vikrom Dhar, MD
Laura A. Lambert, MD
Ryan J. Hendrix, MD
Daniel E. Abbott, MD
Courtney Pokrzywa, MD
Kelly Lafaro, MD
Byrne Lee, MD
Jonathan B. Greer, MD
Nadege Fackche, MD
Andrew M. Lowy, MD
Kaitlyn J. Kelly, MD
Publication date
01-07-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 7/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07373-0

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