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Perioperative Systemic Therapy safe for Resectable Colorectal Peritoneal Metastases
![Perioperative Systemic Therapy safe for Resectable Colorectal Peritoneal Metastases Perioperative Systemic Therapy safe for Resectable Colorectal Peritoneal Metastases](https://medicaldialogues.in/h-upload/2021/05/21/750x450_154045-chemotherapy.webp)
The peritoneum is the second most common isolated metastatic site of colorectal cancer after the liver. Upfront cytoreductive surgery with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the standard treatment for isolated resectable colorectal peritoneal metastases (PM).
In a recent study, researchers reported that perioperative systemic therapy is feasible and safe in patients diagnosed with resectable colorectal peritoneal metastases. The study findings were published in the JAMA Surgery.
So far, no randomized clinical trials have investigated perioperative systemic therapy relative to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy alone for resectable colorectal peritoneal metastases (CPM). Therefore, Dr Koen P. Rovers and his team conducted a study to assess the feasibility and safety of perioperative systemic therapy in patients with resectable CPM and the response of CPM to neoadjuvant treatment.
It was an open-label, parallel-group phase 2 randomized clinical trial of 79 patients from 9 Dutch tertiary centres for the surgical treatment of CPM. They were randomized to perioperative systemic therapy (n = 37) or CRS-HIPEC (n = 42) alone. The major outcome assessed was proportions of macroscopic complete CRS-HIPEC and Clavien-Dindo grade 3 or higher postoperative morbidity. The researchers also assessed the rates of objective radiologic and major pathologic response of CPM to neoadjuvant treatment.
Key findings of the study were:
- Upon analysis, the researchers found no significant difference in the experimental and control arms regarding the proportions of macroscopic complete CRS-HIPEC (33 of 37 [89%] vs 36 of 42 [86%] patients; risk ratio, 1.04) and Clavien-Dindo grade 3 or higher postoperative morbidity (8 of 37 [22%] vs 14 of 42 [33%] patients; risk ratio, 0.65).
- They observed no treatment-related deaths.
- They noted that the objective radiologic and major pathologic response rates of CPM to neoadjuvant treatment were 28% (9 of 32 evaluable patients) and 38% (13 of 34 evaluable patients).
The authors concluded, "In this randomized phase 2 trial in patients diagnosed with resectable CPM, perioperative systemic therapy seemed feasible, safe, and able to induce response of CPM, justifying a phase 3 trial."
For further information:
https://jamanetwork.com/journals/jamasurgery/article-abstract/2780041
Medical Dialogues Bureau consists of a team of passionate medical/scientific writers, led by doctors and healthcare researchers. Our team efforts to bring you updated and timely news about the important happenings of the medical and healthcare sector. Our editorial team can be reached at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751