Incomplete cytoreductive surgery for appendiceal and colorectal peritoneal carcinomatosis: Characteristics and outcomes of an overlooked group Journal Article

   


Authors: Goffredo, P.; Aguirre, N.; Mohamed, M.; Kleiman, D. A.; Cercek, A.; Smith, J. J.; Paty, P. B.; Weiser, M.; Garcia-Aguilar, J.; Nash, G. M.
Article Title: Incomplete cytoreductive surgery for appendiceal and colorectal peritoneal carcinomatosis: Characteristics and outcomes of an overlooked group
Abstract: Background ond Objectives: Complete cytoreductive surgery (CRS) may prolong survival for selected patients with peritoneal carcinomatosis from colorectal cancer (CRC). However, there is a paucity of data on outcomes following incomplete procedures. Methods: Patients with incomplete CRS for well-differentiated (WD) and moderate/poorly-differentiated (M/PD) appendiceal cancer, right and left CRC were identified at a single tertiary center (2008–2021). Results: Of 109 patients, 10% were WD and 51% M/PD appendiceal cancers, and 16% right and 23% left CRC. There were no differences in gender, BMI (mean = 27), ASA score, previous abdominal surgery (72%), and extent of CRS. The PC Index differed between appendiceal and colorectal cancers (mean = 27 vs. 17, p < 0.01). Overall, the perioperative outcomes were similar among the groups, with 15% experiencing complications. Postoperatively, 61% received chemotherapy, and 51% required ≥1 subsequent procedure. The 1 and 3-year survival for the WD, M/PD, right and left CRC subgroups were 100%, 67%, 44%, 51%, and 88%, 17%, 12%, and 23%, respectively (p = 0.02). Conclusions: Incomplete CRS was associated with significant morbidity and number of subsequent palliative procedures. Prognosis correlated with histologic subtype; WD appendiceal cancer patients having superior outcomes, while those with right sided CRC the worst survival. These data may help guiding expectations in the setting of incomplete procedures. © 2023 Wiley Periodicals LLC.
Keywords: adult; cancer chemotherapy; cancer survival; aged; middle aged; survival analysis; survival rate; retrospective studies; major clinical study; overall survival; multimodality cancer therapy; cancer patient; postoperative care; combined modality therapy; outcome assessment; antineoplastic agent; cytoreductive surgery; peritoneal neoplasms; cohort analysis; pathology; retrospective study; postoperative complication; colorectal neoplasms; length of stay; body mass; colorectal tumor; complications; perioperative period; hospital readmission; carcinomatous peritonitis; abdominal surgery; hyperthermia, induced; gender; outcomes; peritoneum tumor; appendix tumor; appendiceal neoplasms; adverse event; metastatic colorectal cancer; colorectal adenocarcinoma; peroperative complication; thermotherapy; clinical outcome; cancer prognosis; humans; prognosis; human; male; female; article; tertiary care center; median survival time; patient history of surgery; cytoreduction surgical procedures; american society of anaesthesiologists score; incomplete cytoreduction; lamn; appendiceal adenocarcinoma
Journal Title: Journal of Surgical Oncology
Volume: 127
Issue: 6
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2023-05-01
Start Page: 1028
End Page: 1034
Language: English
DOI: 10.1002/jso.27223
PUBMED: 36862078
PROVIDER: scopus
PMCID: PMC10079630
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85149374725&doi=10.1002%2fjso.27223&partnerID=40&md5=de31dfbbe56967f4c67594c7e0d4912c
Notes: Article -- Export Date: 1 May 2023 -- Source: Scopus
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MSK Authors
  1. Philip B Paty
    496 Paty
  2. Andrea Cercek Hanjis
    351 Cercek Hanjis
  3. Martin R Weiser
    534 Weiser
  4. Garrett Nash
    261 Nash
  5. Julio Garcia Aguilar
    347 Garcia Aguilar
  6. Jesse Joshua Smith
    217 Smith
  7. David A Kleiman
    2 Kleiman
  8. Paolo Goffredo
    8 Goffredo
  9. Nicole Aguirre
    9 Aguirre
  10. Mostafa Mohamed
    3 Mohamed
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