Histological regression of gastrointestinal peritoneal metastases after systemic chemotherapy.

Details

Ressource 1Download: pp-06-20210118.pdf (709.18 [Ko])
State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_837C8D0E21D8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Histological regression of gastrointestinal peritoneal metastases after systemic chemotherapy.
Journal
Pleura and peritoneum
Author(s)
Toussaint L., Teixeira Farinha H., Barras J.L., Demartines N., Sempoux C., Hübner M.
ISSN
2364-768X (Electronic)
ISSN-L
2364-768X
Publication state
Published
Issued date
09/2021
Peer-reviewed
Oui
Volume
6
Number
3
Pages
113-119
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Peritoneal metastases (PM) are relatively resistant to systemic chemotherapy, and data on histological response to therapy is rare. The aim of this study was to quantify the treatment response of PM after systemic chemotherapy.
Retrospective monocentric cohort study of 47 consecutive patients with PM from gastrointestinal origin undergoing surgery (cytoreduction: CRS + Hyperthermic IntraPEritoneal Chemotherapy [HIPEC] or Pressurized IntraPeritoneal Aerosol Chemotherapy [PIPAC]) after prior systemic chemotherapy from 1.2015 to 3.2019. Tumor response was assessed using the 4-scale Peritoneal Regression Grading System (PRGS) (4: vital tumor to 1: complete response).
Patients had a median of 2 (range: 1-7) lines and 10 (3-39) cycles of prior systemic chemotherapy. A median of four biopsies (range: 3-8) was taken with a total of 196 analyzed specimens. Twenty-four biopsies (12%) showed no histological regression (PRGS4), while PRGS 3, two and one were diagnosed in 37 (19%), 39 (20%), and 69 (49%) specimens, respectively. A significant heterogeneity was found between peritoneal biopsies in 51% patients. PRGS correlated strongly with peritoneal spread (PCI, p<0.0001), and was improved in patients with more than nine cycles of systemic chemotherapy (p=0.04). Median survival was higher in patients with PRGS < 1.8 (Quartiles one and 2) than higher (Q3 and Q4), but the difference did not reach significance in this small cohort.
PRGS is an objective too to describe histological response of PM of GI origin after systemic chemotherapy. This response differs significantly between patients, allowing to distinguish between chemosensitive and chemoresistant tumors.
Keywords
chemotherapy, peritoneal metastasis, peritoneal regression grading system (PRGS), PIPAC
Pubmed
Web of science
Open Access
Yes
Create date
22/10/2021 17:33
Last modification date
21/11/2022 8:24
Usage data