Oxaliplatin versus Mitomycin C following complete cytoreduction for colorectal peritoneal metastases: a comparative study

Abstract

Background and objectives

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can offer selected patients with colorectal peritoneal metastases (CRPM) a favorable long-term survival. While cytoreductive techniques are standardized, there remains great variability in HIPEC drugs with mitomycin C or oxaliplatin use based largely on institute preference. In this study, we compared outcomes based on mitomycin C or oxaliplatin use after complete cytoreduction.

Methods

This is a retrospective analysis over a 7-year period of all patients undergoing complete cytoreduction with HIPEC.

Results

Seventy-eight patients underwent complete cytoreduction with HIPEC during this time. Forty-six patients received oxaliplatin as HIPEC, and 32 received mitomycin C. There was no difference in patient characteristics, resections, or major morbidity between the two groups. Superficial wound infections were higher in the mitomycin C group (37.5% v 15.2%, p = 0.02). Median overall and disease-free survival for the entire cohort was 40 and 14 months, respectively. There was no difference in overall survival or disease-free survival between the two HIPEC groups (HR 0.50, 95% CI 0.11–2.28).

Conclusion

Complete cytoreduction and HIPEC can offer selected patients a favorable survival. The choice of mitomycin C or oxaliplatin for HIPEC had no influence on survival. Prospective studies are needed to explore this important issue.

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Authors

Contributions

VN, SW, MM, RR, and AH produced the study concept and design. VN performed the scientific literature search. VN did the data collection and statistical analysis. All the authors were involved in refining the study design and data interpretation. VN, SW, MM, RR, and AH wrote the initial draft, with all the authors involved in the editing process and final version of the manuscript. All the authors have reviewed and approved the final manuscript. All the authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Vignesh Narasimhan.

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Peter MacCallum Cancer Centre institutional ethics was provided to conduct this comparative study.

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The authors declare that they have no conflicts of interest.

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Narasimhan, V., Warrier, S., Michael, M. et al. Oxaliplatin versus Mitomycin C following complete cytoreduction for colorectal peritoneal metastases: a comparative study. J Gastrointest Surg 24, 2104–2112 (2020). https://doi.org/10.1007/s11605-019-04447-y

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Keywords

  • Colorectal peritoneal metastases
  • Peritonectomy
  • Cytoreduction
  • Hyperthermic intraperitoneal chemotherapy
  • Oxaliplatin HIPEC