(PM P30) Outcomes of CS-HIPEC Among Patients with Colorectal and Appendiceal Adenocarcinoma Versus Signet-ring Cell Carcinoma
Sunday, February 16, 2020
12:35 PM – 12:40 PM
Background: Signet-ring cell (SRC) carcinoma has been associated with worse prognosis and a higher propensity for peritoneal spread. Yet, relative effectiveness of cytoreductive surgery for patients with SRC colorectal carcinomatosis as compared to no-other-specified carcinomas (NOS) has been understudied. Here we examine outcomes of SRC patients treated with surgery and intraoperative chemotherapy.
Methods: We built Cox models on all metastatic colorectal and appendiceal cancer patients (SRC and NOS histo-types) treated by systemic therapy, surgery and intraoperative chemotherapy (proxy for cytoreductive surgery and intraperitoneal chemotherapy) recorded in the National Cancer Data Base between 2004 and 2015.
Results: 323 patients were available for analysis (SRC n=115, NOS n=208; colon n=160, rectum n=16; appendix n=147). SRC patients were of similar age to NOS patients (53.610.6 vs 54.112.1 years, p=0.714). 30-day (1.0% vs 1.2%, p=0.706) and 90-day mortality (7.2% vs 3.5%; p=0.145, respectively) of SRC population was not different from that of NOS. Survival of SRC was significantly shorter (23.9 vs 32.1 months; p=0.019) as compared to NOS patients, while primary disease site did not influence survival. In a regression model adjusted for age, gender and comorbidity status, the SRC histology was associated with worsened survival (aHR=1.54, p=0.015).
Conclusions: Perioperative mortality is similar while long-term survival is significantly reduced among mCRC patients with signet-ring cell histology treated by surgery and intraoperative chemotherapy as compared to no-other-specified metastatic adenocarcinoma patients.