Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified according to the retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin

Joerg O W Pelz, Terence C. Chua, Jesus Esquivel, Alexander Stojadinovic, Joerg Doerfer, David L. Morris, Uwe Maeder, Christoph Thomas Germer, Alexander G. Kerscher

Research output: Contribution to journalArticle

Abstract

Background: We evaluate the long-term survival of patients with peritoneal carcinomatosis (PC) treated with systemic chemotherapy regimens, and the impact of the of the retrospective peritoneal disease severity score (PSDSS) on outcomes.Methods: One hundred sixty-seven consecutive patients treated with PC from colorectal cancer between years 1987-2006 were identified from a prospective institutional database. These patients either received no chemotherapy, 5-FU/Leucovorin or Oxaliplatin/Irinotecan-based chemotherapy. Stratification was made according to the retrospective PSDSS that classifies PC patients based on clinically relevant factors. Survival analysis was performed using the Kaplan-Meier method and comparison with the log-rank test.Results: Median survival was 5 months (95% CI, 3-7 months) for patients who had no chemotherapy, 11 months (95% CI, 6-9 months) for patients treated with 5 FU/LV, and 12 months (95% CI, 4-20 months) for patients treated with Oxaliplatin/Irinotecan-based chemotherapy. Survival differed between patients treated with chemotherapy compared to those patients who did not receive chemotherapy (p = 0.026). PSDSS staging was identified as an independent predictor for survival on multivariate analysis [RR 2.8 (95%CI 1.5-5.4); p <0.001].Conclusion: A trend towards improved outcomes is demonstrated from treatment of patients with PC from colorectal cancer using modern systemic chemotherapy. The PSDSS appears to be a useful tool in patient selection and prognostication in PC of colorectal origin.

LanguageEnglish (US)
Article number689
JournalBMC Cancer
Volume10
DOIs
StatePublished - Dec 22 2010

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Peritoneal Diseases
Carcinoma
Drug Therapy
oxaliplatin
irinotecan
Therapeutics
Survival
Fluorouracil
Colorectal Neoplasms
Leucovorin
Survival Analysis
Patient Selection

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

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Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified according to the retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin. / Pelz, Joerg O W; Chua, Terence C.; Esquivel, Jesus; Stojadinovic, Alexander; Doerfer, Joerg; Morris, David L.; Maeder, Uwe; Germer, Christoph Thomas; Kerscher, Alexander G.

In: BMC Cancer, Vol. 10, 689, 22.12.2010.

Research output: Contribution to journalArticle

Pelz, Joerg O W ; Chua, Terence C. ; Esquivel, Jesus ; Stojadinovic, Alexander ; Doerfer, Joerg ; Morris, David L. ; Maeder, Uwe ; Germer, Christoph Thomas ; Kerscher, Alexander G. / Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified according to the retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin. In: BMC Cancer. 2010 ; Vol. 10.
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abstract = "Background: We evaluate the long-term survival of patients with peritoneal carcinomatosis (PC) treated with systemic chemotherapy regimens, and the impact of the of the retrospective peritoneal disease severity score (PSDSS) on outcomes.Methods: One hundred sixty-seven consecutive patients treated with PC from colorectal cancer between years 1987-2006 were identified from a prospective institutional database. These patients either received no chemotherapy, 5-FU/Leucovorin or Oxaliplatin/Irinotecan-based chemotherapy. Stratification was made according to the retrospective PSDSS that classifies PC patients based on clinically relevant factors. Survival analysis was performed using the Kaplan-Meier method and comparison with the log-rank test.Results: Median survival was 5 months (95{\%} CI, 3-7 months) for patients who had no chemotherapy, 11 months (95{\%} CI, 6-9 months) for patients treated with 5 FU/LV, and 12 months (95{\%} CI, 4-20 months) for patients treated with Oxaliplatin/Irinotecan-based chemotherapy. Survival differed between patients treated with chemotherapy compared to those patients who did not receive chemotherapy (p = 0.026). PSDSS staging was identified as an independent predictor for survival on multivariate analysis [RR 2.8 (95{\%}CI 1.5-5.4); p <0.001].Conclusion: A trend towards improved outcomes is demonstrated from treatment of patients with PC from colorectal cancer using modern systemic chemotherapy. The PSDSS appears to be a useful tool in patient selection and prognostication in PC of colorectal origin.",
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AU - Esquivel, Jesus

AU - Stojadinovic, Alexander

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