Seprafilm: a retrospective preliminary evaluation of the impact on short-term oncologic outcome in colorectal cancer.
BACKGROUND
Hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm ) has been used as a method of postoperative adhesion prevention. However, its short-term effect on colorectal cancer recurrence remains unknown.


METHODS
A retrospective chart review was undertaken of patients with colorectal cancer operated on with curative intent from 1996 to 1999. All patients who received Seprafilm during surgery were assigned to the Seprafilm group, whereas all patients who did not were placed in a control group. Tumor recurrence was defined as persistently elevated carcinoembryonic antigen levels, pathologic confirmation of endoscopic findings, or radiographically documented lesions in the liver, lung, or pelvis.


RESULTS
There were 63 patients in the Seprafilm group and 93 in the control group. The two groups were well matched according to all standard clinical and pathologic characteristics. Adjuvant chemoradiotherapy was administered to 23 patients (36.5 percent) in the Seprafilm group and to 44 (47.3 percent) in the control group ( P= 0.24). At a mean follow-up of 11.4 +/- 7.3 months in the Seprafilm group and 14.2 +/- 11.9 months in the control group, there were 6 (9.5 percent) and 15 (16.1 percent) recurrences, respectively ( P= 0.33). The 1- and 2-year disease-free survival rates were 88 and 85 percent, respectively, in the Seprafilm group and 85 and 72 percent, respectively, in the control group (log-rank test, P= 0.44).


CONCLUSIONS
Seprafilm did not adversely affect the short-term recurrence rate after curative resection of colorectal cancer. In addition, it did not appear to compromise the short-term oncologic outcome. However, with a short follow-up and a small denominator, a definitive conclusion cannot be drawn. This study does intimate that larger, longer-term, prospective, randomized studies may be safely conducted.
Oikonomakis
Ioannis
I
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
Wexner
Steven D
SD
Gervaz
Pascal
P
You
Seong-Yeop
SY
Secic
Michelle
M
Giamundo
Paolo
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012189:Retrospective Studies
D001672:Biocompatible Materials; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid