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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2021

01-02-2021 | Metastasis | Peritoneal Surface Malignancy

Primary Tumor Location and Outcomes After Cytoreductive Surgery and Intraperitoneal Chemotherapy for Peritoneal Metastases of Colorectal Origin

Authors: Mohammad Adileh, MD, Jonathan B. Yuval, MD, Henry S. Walch, MS, Walid K. Chatila, MS, Rona Yaeger, MD, Julio Garcia-Aguilar, MD, PhD, Nikolaus Schultz, PhD, Philip B. Paty, MD, Andrea Cercek, MD, Garrett M. Nash, MD, MPH

Published in: Annals of Surgical Oncology | Issue 2/2021

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Abstract

Background

The aim of this study is to evaluate outcomes in patients with peritoneal metastasis of colorectal cancer (pmCRC) who underwent cytoreductive surgery and intraperitoneal chemotherapy (CRS/IPC) in relation to the location of the primary tumor. Regional therapy, including cytoreductive surgery and intraperitoneal chemotherapy, has been associated with improved survival in patients with pmCRC. Location of the primary tumor has been shown to be prognostic in patients with metastasis.

Patients and Methods

A retrospective review was performed for all patients who underwent complete cytoreduction and intraperitoneal chemotherapy from 2010 to 2017, examining patient and tumor characteristics, overall and recurrence-free survival, recurrence patterns, and tumor mutational profiles.

Results

Ninety-three patients were included in the study: 49 (53%) with a right-sided and 44 (47%) with a left-sided primary tumor. Patients with a right-sided tumor had significantly shorter recurrence-free survival (median, 6.3 months; 95% CI, 4.7–8.1 months vs 12.3 months; 95% CI, 3.6–21.7 months; P = 0.02) and overall survival (median, 36.6 months; 95% CI, 26.4–46.9 months vs 83.3 months; 95% CI 44.2–122.4 months; P = 0.03). BRAF and KRAS mutations were more frequent in right-sided tumors, and APC and TP53 mutations were more frequent in left-sided tumors, which were more chromosomally instable. BRAF mutations were associated with early recurrence.

Conclusions

Tumor sidedness is a predictor of oncological outcomes after CRS/IPC. Tumor sidedness and molecular characteristics should be considered when counseling patients regarding expected outcomes and when selecting or stratifying pmCRC patients for clinical trials of regional therapy.
Appendix
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Metadata
Title
Primary Tumor Location and Outcomes After Cytoreductive Surgery and Intraperitoneal Chemotherapy for Peritoneal Metastases of Colorectal Origin
Authors
Mohammad Adileh, MD
Jonathan B. Yuval, MD
Henry S. Walch, MS
Walid K. Chatila, MS
Rona Yaeger, MD
Julio Garcia-Aguilar, MD, PhD
Nikolaus Schultz, PhD
Philip B. Paty, MD
Andrea Cercek, MD
Garrett M. Nash, MD, MPH
Publication date
01-02-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08993-7

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