Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases
BackgroundThe role of cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy (CRS+HITOC) for patients with secondary pleural metastases has scarcely been investigated.Patients and MethodsWe conducted a retrospective, multicentre study investigating the outcome of CRS+HITOC for 3...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1259779/full |
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| author | Mohamed Hassan Mohamed Hassan Julia Zimmermann Severin Schmid Severin Schmid Bernward Passlick Bernward Passlick Julia Kovács Rudolf Hatz Hauke Winter Hauke Winter Laura V. Klotz Laura V. Klotz Martin E. Eichhorn Martin E. Eichhorn Till Markowiak Karolina Müller Gunnar Huppertz Michael Koller Hans-Stefan Hofmann Hans-Stefan Hofmann Michael Ried |
| author_facet | Mohamed Hassan Mohamed Hassan Julia Zimmermann Severin Schmid Severin Schmid Bernward Passlick Bernward Passlick Julia Kovács Rudolf Hatz Hauke Winter Hauke Winter Laura V. Klotz Laura V. Klotz Martin E. Eichhorn Martin E. Eichhorn Till Markowiak Karolina Müller Gunnar Huppertz Michael Koller Hans-Stefan Hofmann Hans-Stefan Hofmann Michael Ried |
| author_sort | Mohamed Hassan |
| collection | DOAJ |
| description | BackgroundThe role of cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy (CRS+HITOC) for patients with secondary pleural metastases has scarcely been investigated.Patients and MethodsWe 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).ResultsThe 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 vs 38 months; p= 0.048). The median RFS was 14 months (95% CI: 7-21 months).ConclusionsWe 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. |
| first_indexed | 2024-03-09T14:19:19Z |
| format | Article |
| id | doaj.art-1a7a8ac6698142aa8ff55e5f77c952ff |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-09T14:19:19Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-1a7a8ac6698142aa8ff55e5f77c952ff2023-11-28T17:32:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-11-011310.3389/fonc.2023.12597791259779Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastasesMohamed Hassan0Mohamed Hassan1Julia Zimmermann2Severin Schmid3Severin Schmid4Bernward Passlick5Bernward Passlick6Julia Kovács7Rudolf Hatz8Hauke Winter9Hauke Winter10Laura V. Klotz11Laura V. Klotz12Martin E. Eichhorn13Martin E. Eichhorn14Till Markowiak15Karolina Müller16Gunnar Huppertz17Michael Koller18Hans-Stefan Hofmann19Hans-Stefan Hofmann20Michael Ried21Department of Thoracic Surgery, Medical Center—University of Freiburg, Freiburg im Breisgau, GermanyFaculty of Medicine, University of Freiburg, Freiburg im Breisgau, GermanyDepartment of Thoracic Surgery, Ludwig-Maximilians-University of Munich, Asklepios Lung Clinic, Gauting, GermanyDepartment of Thoracic Surgery, Medical Center—University of Freiburg, Freiburg im Breisgau, GermanyFaculty of Medicine, University of Freiburg, Freiburg im Breisgau, GermanyDepartment of Thoracic Surgery, Medical Center—University of Freiburg, Freiburg im Breisgau, GermanyFaculty of Medicine, University of Freiburg, Freiburg im Breisgau, GermanyDepartment of Thoracic Surgery, Ludwig-Maximilians-University of Munich, Asklepios Lung Clinic, Gauting, GermanyDepartment of Thoracic Surgery, Ludwig-Maximilians-University of Munich, Asklepios Lung Clinic, Gauting, GermanyDepartment of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, GermanyDepartment of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, GermanyDepartment of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, GermanyDepartment of Thoracic Surgery, University Hospital Regensburg, Regensburg, GermanyCenter for Clinical Studies, University Hospital Regensburg, Regensburg, GermanyCenter for Clinical Studies, University Hospital Regensburg, Regensburg, GermanyCenter for Clinical Studies, University Hospital Regensburg, Regensburg, GermanyDepartment of Thoracic Surgery, University Hospital Regensburg, Regensburg, GermanyDepartment of Thoracic Surgery, Hospital Barmherzige Brüder Regensburg, Regensburg, GermanyDepartment of Thoracic Surgery, University Hospital Regensburg, Regensburg, GermanyBackgroundThe role of cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy (CRS+HITOC) for patients with secondary pleural metastases has scarcely been investigated.Patients and MethodsWe 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).ResultsThe 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 vs 38 months; p= 0.048). The median RFS was 14 months (95% CI: 7-21 months).ConclusionsWe 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.https://www.frontiersin.org/articles/10.3389/fonc.2023.1259779/fullHITOCcytoreductive surgerypleural metastasesnon-small cell lung cancerhyperthermic intrathoracic chemotherapy |
| spellingShingle | Mohamed Hassan Mohamed Hassan Julia Zimmermann Severin Schmid Severin Schmid Bernward Passlick Bernward Passlick Julia Kovács Rudolf Hatz Hauke Winter Hauke Winter Laura V. Klotz Laura V. Klotz Martin E. Eichhorn Martin E. Eichhorn Till Markowiak Karolina Müller Gunnar Huppertz Michael Koller Hans-Stefan Hofmann Hans-Stefan Hofmann Michael Ried Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases Frontiers in Oncology HITOC cytoreductive surgery pleural metastases non-small cell lung cancer hyperthermic intrathoracic chemotherapy |
| title | Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases |
| title_full | Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases |
| title_fullStr | Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases |
| title_full_unstemmed | Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases |
| title_short | Outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases |
| title_sort | outcome after cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy in patients with secondary pleural metastases |
| topic | HITOC cytoreductive surgery pleural metastases non-small cell lung cancer hyperthermic intrathoracic chemotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1259779/full |
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