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Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases

Background: The role of cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy (CRS+HITOC) for patients with secondary pleural metastases has scarcely been investigated. Patients and Methods: We conducted a retrospective, multicentre study investigating the outcome of CRS+HITOC...

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Main Authors: Hassan, Mohamed (Author) , Zimmermann, Julia (Author) , Schmid, Severin Thomas (Author) , Passlick, Bernward (Author) , Kovács, Julia Regina (Author) , Hatz, Rudolf (Author) , Winter, Hauke (Author) , Klotz, Laura Valentina (Author) , Eichhorn, Martin E. (Author) , Markowiak, Till Marvin (Author) , Müller, Karolina (Author) , Huppertz, Gunnar (Author) , Koller, Michael (Author) , Hofmann, Hans-Stefan (Author) , Ried, Michael (Author)
Format: Article (Journal)
Language:English
Published: 28 November 2023
In: Frontiers in oncology
Year: 2023, Volume: 13, Pages: 1-9
ISSN:2234-943X
DOI:10.3389/fonc.2023.1259779
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fonc.2023.1259779
Verlag, lizenzpflichtig, Volltext: https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1259779/full
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Author Notes:Mohamed Hassan, Julia Zimmermann, Severin Schmid, Bernward Passlick, Julia Kovács, Rudolf Hatz, Hauke Winter, Laura V. Klotz, Martin E. Eichhorn, Till Markowiak, Karolina Müller, Gunnar Huppertz, Michael Koller, Hans-Stefan Hofmann and Michael Ried
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Summary:Background: The role of cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy (CRS+HITOC) for patients with secondary pleural metastases has scarcely been investigated. Patients and Methods: We conducted a retrospective, multicentre study investigating the outcome of CRS+HITOC for 31 patients with pleural metastases from different primary tumours in four high-volume departments of thoracic surgery in Germany. The primary endpoint was overall survival (OS). Secondary endpoints included postoperative complications and recurrence/progression-free survival (RFS/PFS). Results: The primary tumour was non-small cell lung cancer in 12 (39%), ovarian cancer in 5 (16%), sarcoma in 3 (10%), pseudomyxoma peritonei in 3 (10%), and others in 8 (26%) patients. A macroscopic complete resection (R/1) could be achieved in 28 (90%) patients. Major postoperative complications as classified by Clavien-Dindo (III-V) were observed in 11 (35%) patients. The postoperative mortality rate was 10% (n=3). A total of 13 patients received additive chemotherapy (42%). The median time of follow up was 30 months (95% CI = 17- 43). The median OS was 39 months (95% CI: 34-44 months) with 1-month, 3-month, 1-, 3-, and 5-year survival estimates of 97%, 89%, 77%, 66%, and 41%. There was a significantly prolonged OS in patients who received additive chemotherapy compared to patients with only CRS+HITOC (median OS 69 <italic>vs</italic> 38 months; p= 0.048). The median RFS was 14 months (95% CI: 7-21 months). Conclusions: We observed that CRS+HITOC is a feasible approach with reasonable complications and prolonged survival as a part of multimodal concept for highly selected patients with secondary pleural metastases.
Item Description:Gesehen am 27.05.2024
Physical Description:Online Resource
ISSN:2234-943X
DOI:10.3389/fonc.2023.1259779

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