Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC

W J van Eden; N F M Kok; K Woensdregt; A D R Huitema; H. Boot; A G J Aalbers

doi:10.1016/j.ejso.2017.10.216

Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC

W J van Eden, N F M Kok, K Woensdregt, A D R Huitema, H. Boot, A G J Aalbers

Clinical Pharmacy

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Colorectal peritoneal carcinomatosis (PC) is commonly treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is an ongoing international debate about which intraperitoneal chemotherapeutic agent is preferred, Mitomycin C (MMC) or oxaliplatin. We questioned whether the type of chemotherapeutic agent influenced postoperative complication rates or short-term survival. Methods: In this retrospective cohort study patients with colorectal PC who underwent CRS-HIPEC between January 2010 and December 2016 were included. Until March 2014 patients had preferentially been treated with MMC and thereafter with oxaliplatin in an iso-osmotic glucose/electrolyte dialysis (Dianeal ^®) carrier solution. Main outcomes were postoperative complications, disease free survival (DFS) and overall survival (OS). Survival analyses and multivariable analyses were performed. Results: One hundred four patients received MMC and 73 patients oxaliplatin. Postoperative complications did not differ between groups (44.2% (MMC) versus 43.8% (oxaliplatin); P = 0.958). Median DFS was 12.5 months (IQR 6.4–32.4) in the MMC-group and 13.1 months (IQR 6.1-NA) in the oxaliplatin-group (P = 0.669). Median OS was 37.2 months (IQR 17.2-NA) in the MMC-group and 29.4 months (IQR 17.0-NA) in the oxaliplatin-group (P = 0.764). The type of chemotherapeutic agent did not influence OS in multivariable analysis (oxaliplatin versus MMC HR 1.09 (95%CI 0.58–2.06)). The HIPEC-phase was shorter for oxaliplatin (median 32 (IQR 31–34) versus 91 min (IQR 90–92) for MMC (P < 0.001)). Conclusion: Intraperitoneal oxaliplatin reduced the chemoperfusion time when compared to intraperitoneal MMC without adversely influencing complication rates or short-term survival. It may therefore be the preferential drug in CRS-HIPEC procedures for colorectal PC.

Original language	English
Pages (from-to)	220-227
Number of pages	8
Journal	European Journal of Surgical Oncology
Volume	44
Issue number	2
Early online date	15 Nov 2017
DOIs	https://doi.org/10.1016/j.ejso.2017.10.216
Publication status	Published - 2018

Keywords

Colorectal cancer
HIPEC
Mitomycin C
Oxaliplatin
Peritoneal carcinomatosis

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10.1016/j.ejso.2017.10.216

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van Eden, W. J., Kok, N. F. M., Woensdregt, K., Huitema, A. D. R., Boot, H., & Aalbers, A. G. J. (2018). Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC. European Journal of Surgical Oncology, 44(2), 220-227. https://doi.org/10.1016/j.ejso.2017.10.216

@article{87fce187aa7648029d5d9f8220fa8abd,

title = "Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC",

abstract = "Background: Colorectal peritoneal carcinomatosis (PC) is commonly treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is an ongoing international debate about which intraperitoneal chemotherapeutic agent is preferred, Mitomycin C (MMC) or oxaliplatin. We questioned whether the type of chemotherapeutic agent influenced postoperative complication rates or short-term survival. Methods: In this retrospective cohort study patients with colorectal PC who underwent CRS-HIPEC between January 2010 and December 2016 were included. Until March 2014 patients had preferentially been treated with MMC and thereafter with oxaliplatin in an iso-osmotic glucose/electrolyte dialysis (Dianeal {\textregistered}) carrier solution. Main outcomes were postoperative complications, disease free survival (DFS) and overall survival (OS). Survival analyses and multivariable analyses were performed. Results: One hundred four patients received MMC and 73 patients oxaliplatin. Postoperative complications did not differ between groups (44.2% (MMC) versus 43.8% (oxaliplatin); P = 0.958). Median DFS was 12.5 months (IQR 6.4–32.4) in the MMC-group and 13.1 months (IQR 6.1-NA) in the oxaliplatin-group (P = 0.669). Median OS was 37.2 months (IQR 17.2-NA) in the MMC-group and 29.4 months (IQR 17.0-NA) in the oxaliplatin-group (P = 0.764). The type of chemotherapeutic agent did not influence OS in multivariable analysis (oxaliplatin versus MMC HR 1.09 (95%CI 0.58–2.06)). The HIPEC-phase was shorter for oxaliplatin (median 32 (IQR 31–34) versus 91 min (IQR 90–92) for MMC (P < 0.001)). Conclusion: Intraperitoneal oxaliplatin reduced the chemoperfusion time when compared to intraperitoneal MMC without adversely influencing complication rates or short-term survival. It may therefore be the preferential drug in CRS-HIPEC procedures for colorectal PC.",

keywords = "Colorectal cancer, HIPEC, Mitomycin C, Oxaliplatin, Peritoneal carcinomatosis",

author = "{van Eden}, {W J} and Kok, {N F M} and K Woensdregt and Huitema, {A D R} and H. Boot and Aalbers, {A G J}",

note = "Publisher Copyright: {\textcopyright} 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology",

year = "2018",

doi = "10.1016/j.ejso.2017.10.216",

language = "English",

volume = "44",

pages = "220--227",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

publisher = "W.B. Saunders Ltd",

number = "2",

}

van Eden, WJ, Kok, NFM, Woensdregt, K, Huitema, ADR, Boot, H & Aalbers, AGJ 2018, 'Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC', European Journal of Surgical Oncology, vol. 44, no. 2, pp. 220-227. https://doi.org/10.1016/j.ejso.2017.10.216

Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC. / van Eden, W J; Kok, N F M; Woensdregt, K et al.
In: European Journal of Surgical Oncology, Vol. 44, No. 2, 2018, p. 220-227.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC

AU - van Eden, W J

AU - Kok, N F M

AU - Woensdregt, K

AU - Huitema, A D R

AU - Boot, H.

AU - Aalbers, A G J

PY - 2018

Y1 - 2018

N2 - Background: Colorectal peritoneal carcinomatosis (PC) is commonly treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is an ongoing international debate about which intraperitoneal chemotherapeutic agent is preferred, Mitomycin C (MMC) or oxaliplatin. We questioned whether the type of chemotherapeutic agent influenced postoperative complication rates or short-term survival. Methods: In this retrospective cohort study patients with colorectal PC who underwent CRS-HIPEC between January 2010 and December 2016 were included. Until March 2014 patients had preferentially been treated with MMC and thereafter with oxaliplatin in an iso-osmotic glucose/electrolyte dialysis (Dianeal ®) carrier solution. Main outcomes were postoperative complications, disease free survival (DFS) and overall survival (OS). Survival analyses and multivariable analyses were performed. Results: One hundred four patients received MMC and 73 patients oxaliplatin. Postoperative complications did not differ between groups (44.2% (MMC) versus 43.8% (oxaliplatin); P = 0.958). Median DFS was 12.5 months (IQR 6.4–32.4) in the MMC-group and 13.1 months (IQR 6.1-NA) in the oxaliplatin-group (P = 0.669). Median OS was 37.2 months (IQR 17.2-NA) in the MMC-group and 29.4 months (IQR 17.0-NA) in the oxaliplatin-group (P = 0.764). The type of chemotherapeutic agent did not influence OS in multivariable analysis (oxaliplatin versus MMC HR 1.09 (95%CI 0.58–2.06)). The HIPEC-phase was shorter for oxaliplatin (median 32 (IQR 31–34) versus 91 min (IQR 90–92) for MMC (P < 0.001)). Conclusion: Intraperitoneal oxaliplatin reduced the chemoperfusion time when compared to intraperitoneal MMC without adversely influencing complication rates or short-term survival. It may therefore be the preferential drug in CRS-HIPEC procedures for colorectal PC.

AB - Background: Colorectal peritoneal carcinomatosis (PC) is commonly treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is an ongoing international debate about which intraperitoneal chemotherapeutic agent is preferred, Mitomycin C (MMC) or oxaliplatin. We questioned whether the type of chemotherapeutic agent influenced postoperative complication rates or short-term survival. Methods: In this retrospective cohort study patients with colorectal PC who underwent CRS-HIPEC between January 2010 and December 2016 were included. Until March 2014 patients had preferentially been treated with MMC and thereafter with oxaliplatin in an iso-osmotic glucose/electrolyte dialysis (Dianeal ®) carrier solution. Main outcomes were postoperative complications, disease free survival (DFS) and overall survival (OS). Survival analyses and multivariable analyses were performed. Results: One hundred four patients received MMC and 73 patients oxaliplatin. Postoperative complications did not differ between groups (44.2% (MMC) versus 43.8% (oxaliplatin); P = 0.958). Median DFS was 12.5 months (IQR 6.4–32.4) in the MMC-group and 13.1 months (IQR 6.1-NA) in the oxaliplatin-group (P = 0.669). Median OS was 37.2 months (IQR 17.2-NA) in the MMC-group and 29.4 months (IQR 17.0-NA) in the oxaliplatin-group (P = 0.764). The type of chemotherapeutic agent did not influence OS in multivariable analysis (oxaliplatin versus MMC HR 1.09 (95%CI 0.58–2.06)). The HIPEC-phase was shorter for oxaliplatin (median 32 (IQR 31–34) versus 91 min (IQR 90–92) for MMC (P < 0.001)). Conclusion: Intraperitoneal oxaliplatin reduced the chemoperfusion time when compared to intraperitoneal MMC without adversely influencing complication rates or short-term survival. It may therefore be the preferential drug in CRS-HIPEC procedures for colorectal PC.

KW - Colorectal cancer

KW - HIPEC

KW - Mitomycin C

KW - Oxaliplatin

KW - Peritoneal carcinomatosis

U2 - 10.1016/j.ejso.2017.10.216

DO - 10.1016/j.ejso.2017.10.216

M3 - Article

C2 - 29258720

SN - 0748-7983

VL - 44

SP - 220

EP - 227

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 2

ER -

Safety of intraperitoneal Mitomycin C versus intraperitoneal oxaliplatin in patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and HIPEC

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Keywords

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