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Clinical Analysis of HIPEC for T4 Colorectal Cancer After Surgery

ABSTRACT: This multicentric study aims to determine if hyperthermic intraperitoneal chemotherapy (HIPEC) will help to prevent the development of peritoneal carcinomatosis in addition to the standard adjuvant systemic treatment after surgery.

DISEASE(S): Colorectal Cancer,Colorectal Neoplasms

PROVIDER: 2249633 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Surgery With HIPEC in Treating Patients With a High Risk of Developing Colorectal Peritoneal Carcinomatosis

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Adjuvant HIPEC in High Risk Colon Cancer

Project description:This study aims to determine the oncological effectiveness of adjuvant HIPEC, using intraperitoneal oxaliplatin with concomitant i.v. 5-FU/LV, following a curative resection of a T4 or intra-abdominally perforated Colon cancer in preventing the development of peritoneal carcinomatosis in addition to the standard adjuvant systemic treatment. Hypothesis: The hypothesis is that adjuvant HIPEC preceding routine adjuvant systemic therapy using i.p. oxaliplatin with concomitant i.v. 5-FU/LV following a curative resection of a T4 or intra-abdominally perforated colon cancer reduces the development of peritoneal carcinomatosis in comparison to standard adjuvant systemic treatment alone.

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Combined Anticancer Treatment of Advanced Colon Cancer

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HIPEC and Systemic Chemotherapy in Unresectable Peritoneal Metastases From Colorectal Cancer

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Global gene expression and Stromal contents improve prognostic power in PMP patients treated by CRS+HIPEC

Project description:In recent years, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have substantially improved the clinical outcome of pseudomyxoma peritonei (PMP) originating from mucinous appendiceal cancer. However, current histopathological grading of appendiceal PMP frequently fails in predicting disease outcome. We recently observed that the integration of cancer cell transcriptional traits with those of cancer-associated fibroblasts (CAFs) improves prognostic prediction for tumors of the large intestine. We therefore generated global expression profiles on a consecutive series of 24 PMP patients treated with CRS plus HIPEC. Multiple lesions were profiled for nine patients. We then used expression data to stratify the samples by a previously published "high-risk appendiceal cancer" (HRAC) signature and by a CAF signature that we previously developed for colorectal cancer, or by a combination of both. The prognostic value of the HRAC signature was confirmed in our cohort and further improved by integration of the CAF signature. Classification of cases profiled for multiple lesions revealed the existence of outlier samples and highlighted the need of profiling multiple PMP lesions to select representative samples for optimal performances. The integrated predictor was subsequently validated in an independent PMP cohort. These results provide new insights into PMP biology, revealing a previously unrecognized prognostic role of the stromal component and supporting integration of standard pathological grade with the HRAC and CAF transcriptional signatures to better predict disease outcome.

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Gene expresssion profiles of cancer of the appendix

Project description:Appendiceal cancer patients treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) often demonstrate an unpredictable variability in survival outcomes. Biomarkers predictive of CRS/HIPEC efficacy could better guide treatment decisions. In this study we hypothesized that variation in the transcriptional programming of appendiceal tumors might distinguish molecular subtypes with differential outcomes after CRS/HIPEC. The goal of this study was to investigate the potential of a prognostic gene signature to discriminate patients with favorable and unfavorable outcomes in a “discovery” set of patient (the original tumor series (n=24)), and confirm its prognostic value in a second “validation” series (the validation cohort (n=39)).

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