Perioperative Systemic Therapy Versus Cytoreductive Surgery and HIPEC Alone for Resectable Colorectal Peritoneal Metastases: Patient-Reported Outcomes of a Randomized Phase II Trial

the Dutch Peritoneal Oncology Group and the Dutch Colorectal Cancer Group, C. Bakkers, K. P. Rovers, A. Rijken, G. A.A.M. Simkens, C. S. Bonhof, S. W. Nienhuijs, J. W.A. Burger, G. J.M. Creemers, A. R.M. Brandt-Kerkhof, J. B. Tuynman, A. G.J. Aalbers, M. J. Wiezer, P. R. de Reuver, W. M.U. van Grevenstein, P. H.J. Hemmer, C. J.A. Punt, P. J. Tanis, F. Mols, I. H.J.T. de Hingh*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

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Background: As part of a randomized phase II trial in patients with isolated resectable colorectal peritoneal metastases (CPMs), the present study compared patient-reported outcomes (PROs) of patients treated with perioperative systemic therapy versus cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) alone. Also, PROs of patients receiving perioperative systemic therapy were explored.

Patients and Methods: Eligible patients were randomized to perioperative systemic therapy (experimental) or CRS–HIPEC alone (control). PROs were assessed using EORTC QLQ-C30, QLQ-CR29, and EQ-5D-5L questionnaires at baseline, after neoadjuvant treatment (experimental), and at 3 and 6 months postoperatively. Linear mixed modeling was used to compare five predefined PROs (visual analog scale, global health status, physical functioning, fatigue, C30 summary score) between arms and to longitudinally analyze PROs in the experimental arm.

Results: Of 79 analyzed patients, 37 (47%) received perioperative systemic therapy. All predefined PROs were comparable between arms at all timepoints and returned to baseline at 3 or 6 months postoperatively. The experimental arm had worsening of fatigue [mean difference (MD) + 14, p = 0.001], loss of appetite (MD + 15, p = 0.003), hair loss (MD + 18, p < 0.001), and loss of taste (MD + 27, p < 0.001) after neoadjuvant treatment. Except for loss of appetite, these PROs returned to baseline at 3 or 6 months postoperatively.

Conclusions: In patients with resectable CPM randomized to perioperative systemic therapy or CRS–HIPEC alone, PROs were comparable between arms and returned to baseline postoperatively. Together with the trial’s previously reported feasibility and safety data, these findings show acceptable tolerability of perioperative systemic therapy in this setting.

Originele taal-2English
Pagina's (van-tot)2678-2688
Aantal pagina's11
TijdschriftAnnals of surgical oncology
Volume30
Nummer van het tijdschrift5
DOI's
StatusPublished - mei-2023

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