BACKGROUND: Carcinomatosis of colorectal origin is increasingly treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CS-HIPEC). This procedure commonly involves multivisceral resection (MVR) with potentially high morbidity. We analyzed the effect of MVR on the outcome after CS-HIPEC. METHODS: All patients with colorectal carcinomatosis operated between June 2001 and June 2007 were included. MVR was defined as resection of two or more organs (n = 35). Patients without any or with a single visceral resection formed a control group (n = 30). RESULTS: Sixty-five patients underwent 72 procedures. MVR was not strongly associated with the mortality, morbidity, reoperation, or readmission. Morbidity, but not mortality, was more common in patients requiring bowel anastomosis (36 of 51 vs. 7 of 21, P = .003). Median survival from the diagnosis of carcinomatosis was not significantly different between the MVR and controls (32.8 months vs. 20.0 months, P = .787). Similarly, the median survival from the time of cytoreduction was not significantly different (20.2 vs. 14.3 months; P = .436). Independent predictors of survival in the Cox regression model were presence of residual disease >5 mm (hazard ratio = 4.5, P = .048), evidence of carcinomatosis on preoperative computed tomographic scan (6.1, P = .008), and initial diagnosis of cancer as systemic (2.6, P = .049). MVR had no statistically significant effect on survival (.441, P = .133). CONCLUSIONS: Increased risk of complications is associated with the number of intestinal anastomoses, but not with multivisceral resection in CS-HIPEC. Long-term survival is not affected by the number of resected organs.
BACKGROUND:Carcinomatosis of colorectal origin is increasingly treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CS-HIPEC). This procedure commonly involves multivisceral resection (MVR) with potentially high morbidity. We analyzed the effect of MVR on the outcome after CS-HIPEC. METHODS: All patients with colorectal carcinomatosis operated between June 2001 and June 2007 were included. MVR was defined as resection of two or more organs (n = 35). Patients without any or with a single visceral resection formed a control group (n = 30). RESULTS: Sixty-five patients underwent 72 procedures. MVR was not strongly associated with the mortality, morbidity, reoperation, or readmission. Morbidity, but not mortality, was more common in patients requiring bowel anastomosis (36 of 51 vs. 7 of 21, P = .003). Median survival from the diagnosis of carcinomatosis was not significantly different between the MVR and controls (32.8 months vs. 20.0 months, P = .787). Similarly, the median survival from the time of cytoreduction was not significantly different (20.2 vs. 14.3 months; P = .436). Independent predictors of survival in the Cox regression model were presence of residual disease >5 mm (hazard ratio = 4.5, P = .048), evidence of carcinomatosis on preoperative computed tomographic scan (6.1, P = .008), and initial diagnosis of cancer as systemic (2.6, P = .049). MVR had no statistically significant effect on survival (.441, P = .133). CONCLUSIONS: Increased risk of complications is associated with the number of intestinal anastomoses, but not with multivisceral resection in CS-HIPEC. Long-term survival is not affected by the number of resected organs.
Authors: Pinuccia Faviana; Laura Boldrini; Barbara Musco; Mauro Ferrari; Alfonso Greco; Lorenzo Fornaro; Gianluca Masi; Francesco Forfori; Sergio Ricci; Augusto Brogi; Fulvio Basolo; Alfredo Falcone; Angelo Gadducci; Piero Vincenzo Lippolis Journal: In Vivo Date: 2020 Jul-Aug Impact factor: 2.155
Authors: Stephanie Downs-Canner; Yongli Shuai; Lekshmi Ramalingam; James F Pingpank; Matthew P Holtzman; Herbert J Zeh; David L Bartlett; Haroon A Choudry Journal: J Surg Res Date: 2017-06-29 Impact factor: 2.192
Authors: Patrick L Wagner; Frances Austin; Ugwuji Maduekwe; Arun Mavanur; Lekshmi Ramalingam; Heather L Jones; Matthew P Holtzman; Steven A Ahrendt; Amer H Zureikat; James F Pingpank; Herbert J Zeh; David L Bartlett; Haroon A Choudry Journal: Ann Surg Oncol Date: 2013-03-02 Impact factor: 5.344