Clinical Research Papers:
Curative versus palliative treatments for colorectal cancer with peritoneal carcinomatosis: a systematic review and meta-analysis
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Abstract
Wenqiong Wu1, Shipeng Yan2, Xianzhen Liao2, Haifang Xiao2, Zhongxi Fu3, Lizhang Chen4, Jinsong Mou5, Haibo Yu6, Lian Zhao7,8 and Xiangguo Liu2
1Department of Radiation Oncology, Hunan Cancer Hospital–The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
2Department of Cancer Prevention and Control, Hunan Cancer Hospital–The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
3Department of Chronic Diseases Prevention and Control, Centers for Disease Control and Prevention of Hunan, Changsha, Hunan Province, China
4Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China
5Department of Epidemiology and Health Statistics, Changsha Medical University, Changsha, Hunan Province, China
6Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
7Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
8Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, Hunan Province, China
Correspondence to:
Shipeng Yan, email: [email protected]
Keywords: meta-analysis, cytoreductive surgery, intraperitoneal chemotherapy, colorectal cancer, peritoneal carcinomatosis
Received: June 08, 2017 Accepted: October 05, 2017 Published: October 20, 2017
ABSTRACT
The objective of this study was to provide an up-to-date summary of the current evidence that may be useful for updating guidelines. We comprehensively searched the published literatures and conferences for studies that compared curative with palliative treatments in colorectal cancer patients with peritoneal metastasis. The primary outcomes considered in this study were three- and five-year overall survival rates. We pooled data across studies and estimated summary effect sizes. Overall, patients who received curative treatments had improved three-year survival (hazard ratio (HR), 2.19 [95% CI, 1.83 to 2.62]) and five-year survival (HR, 2.22 [95% CI, 1.83 to 2.69]) compared with those who received palliative treatments. Patients who received curative treatments had an increased risk of treatment-related morbidity (odds ratio (OR), 2.90 [95% CI, 2.02 to 4.17]), but there was no significant difference in treatment-related mortality between patients who received curative treatments and those who received palliative treatments (OR, 1.46 [CI, 0.62 to 3.47]). Curative treatments improved overall survival in colorectal cancer patients with peritoneal metastasis and did not increase the risk of treatment-related mortality. Curative treatments were associated with a higher risk of treatment-related morbidity. These data highlight the importance for further investigation aimed at prevention of treatment-associated morbidity.
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