In a nutshell
This study investigated two treatment options for patients with cancer that has spread to the peritoneum (the lining of the abdominal cavity).
A common location for colorectal cancer to spread is the peritoneum. The best way to treat patients with peritoneal invasion is with cytoreductive surgery plus intraperitoneal chemotherapy (CS/IPC). CS/IPC involves surgically removing affected parts of the peritoneum and then bathing the abdominal cavity in chemotherapy. However, CS/IPC is a risky procedure and in some cases it may not benefit the patient. Predicting which patients would benefit from CS/IPC would help minimize any unnecessary risk to patients.
Methods & findings
This study included 180 colorectal cancer patients who underwent treatment for peritoneal invasion. CS/IPC was performed in 77% of the patients, while 23% of patients were not eligible for CS/IPC and received routine chemotherapy instead. The severity of peritoneal cancer was scored from 0 to 39 (scores above 16-20 are normally linked to worse outcome). Patients were followed for an average of 60 months.
At the beginning of the study the CS/IPC group had a lower average peritoneal cancer score (average score 11) than the chemotherapy group (average score 23). At the end of the follow-up period 52% of patients in the CS/IPC group were still alive, compared to only 7% of the chemotherapy group. Rates of survival did not differ significantly between the two groups if patients had a peritoneal cancer score above 17.
Overall, patients with lower peritoneal cancer scores had a better chance of survival compared to patients with higher scores. The risk of death was 6.74 fold higher for patients with a score between 16 and 20 and 11.70 fold higher for patients with a score between 20 and 39, compared to patients with a score between 1 and 4.
The bottom line
The authors concluded that CS/IPC extends patient survival only if they have a peritoneal cancer score below 17. They suggest that doctors and patients should be aware that if the score is above 17 the benefits of CS/IPS may not outweigh the risks of the treatment.
Published By :
Annals of Surgical Oncology
Jan 29, 2015
If you sign up for Medivizor, you'll receive PERSONALIZED updates that are JUST FOR YOU. Want to give it a try?