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Comparative Study
. 2010 Dec 22:10:689.
doi: 10.1186/1471-2407-10-689.

Evaluation of best supportive care and systemic chemotherapy as treatment stratified according to the retrospective peritoneal surface disease severity score (PSDSS) for peritoneal carcinomatosis of colorectal origin

Joerg O W Pelz  1 , Terence C Chua, Jesus Esquivel, Alexander Stojadinovic, Joerg Doerfer, David L Morris, Uwe Maeder, Christoph-Thomas Germer, Alexander G Kerscher
Affiliations
Comparative Study

Evaluation of best supportive care and systemic chemotherapy as treatment stratified according to the retrospective peritoneal surface disease severity score (PSDSS) for peritoneal carcinomatosis of colorectal origin

Joerg O W Pelz et al. BMC Cancer. .

Abstract

Background: We evaluate the long-term survival of patients with peritoneal carcinomatosis (PC) treated with systemic chemotherapy regimens, and the impact of the of the retrospective peritoneal disease severity score (PSDSS) on outcomes.

Methods: One hundred sixty-seven consecutive patients treated with PC from colorectal cancer between years 1987-2006 were identified from a prospective institutional database. These patients either received no chemotherapy, 5-FU/Leucovorin or Oxaliplatin/Irinotecan-based chemotherapy. Stratification was made according to the retrospective PSDSS that classifies PC patients based on clinically relevant factors. Survival analysis was performed using the Kaplan-Meier method and comparison with the log-rank test.

Results: Median survival was 5 months (95% CI, 3-7 months) for patients who had no chemotherapy, 11 months (95% CI, 6-9 months) for patients treated with 5 FU/LV, and 12 months (95% CI, 4-20 months) for patients treated with Oxaliplatin/Irinotecan-based chemotherapy. Survival differed between patients treated with chemotherapy compared to those patients who did not receive chemotherapy (p = 0.026). PSDSS staging was identified as an independent predictor for survival on multivariate analysis [RR 2.8 (95%CI 1.5-5.4); p < 0.001].

Conclusion: A trend towards improved outcomes is demonstrated from treatment of patients with PC from colorectal cancer using modern systemic chemotherapy. The PSDSS appears to be a useful tool in patient selection and prognostication in PC of colorectal origin.

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Figures

Figure 1
Figure 1
Survival of 167 patients with isolated peritoneal carcinomatosis or peritoneal carcinomatosis as a combined site of disease with less than two other metastatic sites.
Figure 2
Figure 2
Survival stratified by type of chemotherapy treatment (no chemo vs. 5FU/L and modern systemic chemotherapy; p = 0.026).
Figure 3
Figure 3
Survival according to Peritoneal Surface Disease Severity Score Stage I to IV.
Figure 4
Figure 4
Survival stratified by PSDSS Stage I/II, PSDSS Stage III and PSDSS Stage IV.
Figure 5
Figure 5
Survival stratified by PSDSS Stage I/II by no chemotherapy, 5FU/L, modern combination systemic chemotherapy (no chemo v.s. 5FU/L and combination.
See this image and copyright information in PMC

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