Evaluation of a peritoneal surface disease severity score in patients with colon cancer with peritoneal carcinomatosis

Joerg O W Pelz, Alexander Stojadinovic, Aviram Nissan, Werner Hohenberger, Jesus Esquivel

Research output: Contribution to journalArticle

Abstract

Introduction: Systemic therapy and cytoreduction (CRS) with hyperthermic intra-peritoneal chemotherapy (HIPEC) may benefit selected patients with carcinomatosis from colon cancer (PC). This study presents the results of a consecutive series of patients evaluated under a single strategy. Patients and Methods: Forty patients with PC referred for CRS were evaluated. Evaluation of their treatment was determined according to disease severity scored on a 3-point scale including: (1) symptoms, (2) extent of peritoneal dissemination (PCI), and (3) primary tumor histology. Overall survival (OS) was analyzed using Kaplan-Meier product-limit method and log rank testing according to four tiers of estimated disease severity based on the above parameters. Results: For patients with disease severity score I, II, III, and IV, 2-year OS following treatment was 100%, 80%, 80%, and 0%, respectively. Median OS with most advanced disease (IV: n=20) was 5 months versus 36 months for disease of lesser severity (I-III: n = 20; P <0.001; RR = 0.2; 95%CI 0.1-0.5). Advanced disease (IV) was an independent predictor of adverse outcome on multivariate analysis with 2.6-fold increased likelihood of mortality. Conclusion: A treatment strategy based on disease severity determined at time of diagnosis, stratifies patients into prognostic groups and may improve selection of patients for appropriate therapy.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalJournal of Surgical Oncology
Volume99
Issue number1
DOIs
StatePublished - Jan 1 2009

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Peritoneal Diseases
Colonic Neoplasms
Carcinoma
Survival
Therapeutics
Kaplan-Meier Estimate
Patient Selection
Histology
Multivariate Analysis
Drug Therapy
Mortality

Keywords

  • Carcinomatosis
  • Colon cancer
  • Peritoneal surface malignancy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Evaluation of a peritoneal surface disease severity score in patients with colon cancer with peritoneal carcinomatosis. / Pelz, Joerg O W; Stojadinovic, Alexander; Nissan, Aviram; Hohenberger, Werner; Esquivel, Jesus.

In: Journal of Surgical Oncology, Vol. 99, No. 1, 01.01.2009, p. 9-15.

Research output: Contribution to journalArticle

Pelz, Joerg O W ; Stojadinovic, Alexander ; Nissan, Aviram ; Hohenberger, Werner ; Esquivel, Jesus. / Evaluation of a peritoneal surface disease severity score in patients with colon cancer with peritoneal carcinomatosis. In: Journal of Surgical Oncology. 2009 ; Vol. 99, No. 1. pp. 9-15.
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