Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis
Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective measure for improving the prognosis of colorectal cancer (CRC) patients with peritoneal carcinomatosis (PC). However, the role of HIPEC in CRC patients at high risk of PC remains controversial. The current systematic revie...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2020.590452/full |
| _version_ | 1818157704285257728 |
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| author | Peng-yue Zhao Shi-dong Hu Yu-xuan Li Ren-qi Yao Ren-qi Yao Chao Ren Chang-zheng He Song-yan Li Yu-feng Wang Yong-ming Yao Xiao-hui Huang Xiao-hui Du |
| author_facet | Peng-yue Zhao Shi-dong Hu Yu-xuan Li Ren-qi Yao Ren-qi Yao Chao Ren Chang-zheng He Song-yan Li Yu-feng Wang Yong-ming Yao Xiao-hui Huang Xiao-hui Du |
| author_sort | Peng-yue Zhao |
| collection | DOAJ |
| description | Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective measure for improving the prognosis of colorectal cancer (CRC) patients with peritoneal carcinomatosis (PC). However, the role of HIPEC in CRC patients at high risk of PC remains controversial. The current systematic review and meta-analysis aimed to evaluate the clinical efficacy and safety of HIPEC in CRC patients at high risk of PC.Methods: We performed a systematic search of PubMed, Embase, Cochrane Library, and other online databases up to July 30, 2020. The clinical data, including overall survival, disease free survival, peritoneal metastasis rate, and postoperative adverse reaction were screened and analyzed after data extraction. Risk ratios (RRs) were applied to analyze these dichotomous outcomes with a random effects model.Results: A total of 6 available clinical studies involving 603 patients were finally included. CRC patients at high risk of PC who proactively underwent HIPEC treatment showed a significantly reduced peritoneal metastasis rate (RR: 0.41, 95% CI: 0.21–0.83, P = 0.01; I2 = 58%) compared to the similarly high-risk in CRC patients who did not receive HIPEC treatment. However, in terms of overall survival (RR: 1.13, 95% CI: 0.97–1.33, P = 0.12; I2 = 77%), disease-free survival (RR: 1.10, 95% CI: 0.75–1.59, P = 0.63; I2 = 53%), progression free survival (RR: 1.85, 95% CI: 0.48–7.14, P = 0.37; I2 = 93%), and postoperative adverse reactions (RR: 0.1.07, 95% CI: 0.36–3.15, P = 0.90; I2 = 78%), there was no significant difference between the HIPEC treatment and control groups.Conclusions: Proactive HIPEC treatment did not show the expected clinical efficacy in prolonging the overall survival time, disease-free survival time, and progression-free survival time of CRC patients at high risk of PC. However, the preemptive administration of HIPEC was associated with a reduced peritoneal metastasis rate and did not cause adverse additional postoperative effects. |
| first_indexed | 2024-12-11T15:18:25Z |
| format | Article |
| id | doaj.art-d6a5597fb9214374b5fd2ec34899b6b7 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-12-11T15:18:25Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-d6a5597fb9214374b5fd2ec34899b6b72022-12-22T01:00:28ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2020-11-01710.3389/fsurg.2020.590452590452Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-AnalysisPeng-yue Zhao0Shi-dong Hu1Yu-xuan Li2Ren-qi Yao3Ren-qi Yao4Chao Ren5Chang-zheng He6Song-yan Li7Yu-feng Wang8Yong-ming Yao9Xiao-hui Huang10Xiao-hui Du11Department of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaTrauma Research Center, Fourth Medical Center of the Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, ChinaTrauma Research Center, Fourth Medical Center of the Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of Patient Admission Management, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaTrauma Research Center, Fourth Medical Center of the Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaDepartment of General Surgery, First Medical Center of Chinese People's Liberarion Army General Hospital, Beijing, ChinaBackground: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective measure for improving the prognosis of colorectal cancer (CRC) patients with peritoneal carcinomatosis (PC). However, the role of HIPEC in CRC patients at high risk of PC remains controversial. The current systematic review and meta-analysis aimed to evaluate the clinical efficacy and safety of HIPEC in CRC patients at high risk of PC.Methods: We performed a systematic search of PubMed, Embase, Cochrane Library, and other online databases up to July 30, 2020. The clinical data, including overall survival, disease free survival, peritoneal metastasis rate, and postoperative adverse reaction were screened and analyzed after data extraction. Risk ratios (RRs) were applied to analyze these dichotomous outcomes with a random effects model.Results: A total of 6 available clinical studies involving 603 patients were finally included. CRC patients at high risk of PC who proactively underwent HIPEC treatment showed a significantly reduced peritoneal metastasis rate (RR: 0.41, 95% CI: 0.21–0.83, P = 0.01; I2 = 58%) compared to the similarly high-risk in CRC patients who did not receive HIPEC treatment. However, in terms of overall survival (RR: 1.13, 95% CI: 0.97–1.33, P = 0.12; I2 = 77%), disease-free survival (RR: 1.10, 95% CI: 0.75–1.59, P = 0.63; I2 = 53%), progression free survival (RR: 1.85, 95% CI: 0.48–7.14, P = 0.37; I2 = 93%), and postoperative adverse reactions (RR: 0.1.07, 95% CI: 0.36–3.15, P = 0.90; I2 = 78%), there was no significant difference between the HIPEC treatment and control groups.Conclusions: Proactive HIPEC treatment did not show the expected clinical efficacy in prolonging the overall survival time, disease-free survival time, and progression-free survival time of CRC patients at high risk of PC. However, the preemptive administration of HIPEC was associated with a reduced peritoneal metastasis rate and did not cause adverse additional postoperative effects.https://www.frontiersin.org/articles/10.3389/fsurg.2020.590452/fullcolorectal cancerHIPECperitoneal carcinomatosissurvivalmeta- analysis |
| spellingShingle | Peng-yue Zhao Shi-dong Hu Yu-xuan Li Ren-qi Yao Ren-qi Yao Chao Ren Chang-zheng He Song-yan Li Yu-feng Wang Yong-ming Yao Xiao-hui Huang Xiao-hui Du Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis Frontiers in Surgery colorectal cancer HIPEC peritoneal carcinomatosis survival meta- analysis |
| title | Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis |
| title_full | Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis |
| title_fullStr | Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis |
| title_short | Clinical Efficacy and Safety of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer Patients at High Risk of Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis |
| title_sort | clinical efficacy and safety of hyperthermic intraperitoneal chemotherapy in colorectal cancer patients at high risk of peritoneal carcinomatosis a systematic review and meta analysis |
| topic | colorectal cancer HIPEC peritoneal carcinomatosis survival meta- analysis |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2020.590452/full |
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