Histological regression of gastrointestinal peritoneal metastases after systemic chemotherapy.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_837C8D0E21D8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Histological regression of gastrointestinal peritoneal metastases after systemic chemotherapy.
Périodique
Pleura and peritoneum
Auteur⸱e⸱s
Toussaint L., Teixeira Farinha H., Barras J.L., Demartines N., Sempoux C., Hübner M.
ISSN
2364-768X (Electronic)
ISSN-L
2364-768X
Statut éditorial
Publié
Date de publication
09/2021
Peer-reviewed
Oui
Volume
6
Numéro
3
Pages
113-119
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
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.
Mots-clé
chemotherapy, peritoneal metastasis, peritoneal regression grading system (PRGS), PIPAC
Pubmed
Web of science
Open Access
Oui
Création de la notice
22/10/2021 18:33
Dernière modification de la notice
26/11/2021 8:11
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