Repeat Cytoreductive Surgery-Hyperthermic Intraperitoneal Chemoperfusion is Feasible and Offers Survival Benefit in Select Patients with Peritoneal Metastases View Full Text


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Article Info

DATE

2019-03-01

AUTHORS

Haroon A. Choudry, Filip Bednar, Yongli Shuai, Heather L. Jones, Reetesh K. Pai, James F. Pingpank, Steven S. Ahrendt, Matthew P. Holtzman, Herbert J. Zeh, David L. Bartlett

ABSTRACT

INTRODUCTION: We hypothesized that repeat cytoreductive surgery-hyperthermic intraperitoneal chemoperfusion (CRS-HIPEC) for peritoneal metastases (PM) may be associated with suboptimal resection, more frequent postoperative complications, and worse oncologic outcomes. METHODS: Using a prospectively maintained database, we compared clinicopathologic, perioperative, and oncologic outcome data in patients undergoing single or repeat CRS-HIPEC procedures. The Kaplan-Meier method was used to estimate survival. Multivariate analyses identified associations with perioperative and oncologic outcomes. RESULTS: Of the 1294 patients undergoing CRS-HIPEC procedures at our institution, only one CRS-HIPEC procedure (single HIPEC cohort) was performed in 1169 patients (90.3%), whereas 125 patients (9.7%) underwent repeat CRS-HIPEC procedures (repeat HIPEC cohort). Of the 1440 CRS-HIPEC procedures at our institution, a first CRS-HIPEC procedure was performed in 1294 patients (89.9%), whereas subsequent second, third, and fourth CRS-HIPEC procedures were performed in 125 patients (8.7%), 18 patients (1.3%), and 3 patients (0.2%), respectively. Progression-free survival (PFS) following the second CRS-HIPEC procedure was negatively impacted by shorter PFS following the first CRS-HIPEC procedure, independent of other significant variables related to the second procedure, including completeness of cytoreduction and postoperative complications. Patients undergoing multiple CRS-HIPEC procedures were not at higher risk for suboptimal resection or postoperative complications and demonstrated equivalent PFS following each successive procedure compared to the first procedure. CONCLUSIONS: Repeat CRS-HIPEC procedures for PM were not associated with suboptimal perioperative and oncologic outcomes. Our data confirmed our ability to select patients appropriately for repeat CRS-HIPEC procedures. More... »

PAGES

1-9

References to SciGraph publications

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  • 2016-12. Repeated cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with recurrent peritoneal carcinomatosis in WORLD JOURNAL OF SURGICAL ONCOLOGY
  • 2015-06. Repeat Cytoreductive Surgery and HIPEC for Peritoneal Surface Malignancy and Peritoneal Carcinomatosis in WORLD JOURNAL OF SURGERY
  • 2009-10. The Second Procedure Combining Complete Cytoreductive Surgery and Intraperitoneal Chemotherapy for Isolated Peritoneal Recurrence: Postoperative Course and Long-Term Outcome in ANNALS OF SURGICAL ONCOLOGY
  • 2007-08. Critical Analysis of Treatment Failure After Complete Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Peritoneal Dissemination From Appendiceal Mucinous Neoplasms in ANNALS OF SURGICAL ONCOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1245/s10434-019-07218-w

    DOI

    http://dx.doi.org/10.1245/s10434-019-07218-w

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112468361

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30825033


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