BACKGROUND AND OBJECTIVES: Morbidity after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) for colorectal peritoneal carcinomatosis (PC) may negatively affect survival. The objective was to determine the impact of postoperative complications (CX) on survival in patients undergoing CRS + HIPEC for colorectal PC. METHODS: All patients undergoing laparotomy for planned CRS + HIPEC for colorectal PC at a single institution from 1999 to 2014 were included. Patients were divided into three groups: CRS + HIPEC without CX (+HIPEC-CX); CRS + HIPEC with postoperative complication (+HIPEC + CX); and aborted CRS and HIPEC due to unresectable disease (-HIPEC). Postoperative morbidity were defined as Clavien II+ complications. Kaplan-Meier survival analyses and multivariable Cox proportional hazard modeling were used to describe the disease-free (DFS) and overall survival (OS). RESULTS: One hundred and twenty-two patients were included in the analysis (50 +HIPEC - CX, 40 +HIPEC + CX, 32-HIPEC). Overall complication rate was 42%. OS at 1-, 3-, and 5-years in patients undergoing successful CRS + HIPEC were 97%, 67%, and 45%. CX after successful CRS + HIPEC was independently associated with worsened OS (HR1.58, 95%CI, 1.19-1.97) but not DFS (HR1.11, 95%CI, 0.56-2.20). PCI also independently predicted worsened DFS (HR1.12, 95%CI, 1.06-1.18) and OS (HR1.08, 95%CI, 1.04-1.12). Patients with unresectable disease had significantly worse OS (HR6.50, 95%CI, 1.37-7.01). CONCLUSIONS: CX after CRS + HIPEC significantly affect OS. Patient selection and perioperative care are of paramount importance in the management of CRS + HIPEC for colorectal PC.
BACKGROUND AND OBJECTIVES: Morbidity after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) for colorectal peritoneal carcinomatosis (PC) may negatively affect survival. The objective was to determine the impact of postoperative complications (CX) on survival in patients undergoing CRS + HIPEC for colorectal PC. METHODS: All patients undergoing laparotomy for planned CRS + HIPEC for colorectal PC at a single institution from 1999 to 2014 were included. Patients were divided into three groups: CRS + HIPEC without CX (+HIPEC-CX); CRS + HIPEC with postoperative complication (+HIPEC + CX); and aborted CRS and HIPEC due to unresectable disease (-HIPEC). Postoperative morbidity were defined as Clavien II+ complications. Kaplan-Meier survival analyses and multivariable Cox proportional hazard modeling were used to describe the disease-free (DFS) and overall survival (OS). RESULTS: One hundred and twenty-two patients were included in the analysis (50 +HIPEC - CX, 40 +HIPEC + CX, 32-HIPEC). Overall complication rate was 42%. OS at 1-, 3-, and 5-years in patients undergoing successful CRS + HIPEC were 97%, 67%, and 45%. CX after successful CRS + HIPEC was independently associated with worsened OS (HR1.58, 95%CI, 1.19-1.97) but not DFS (HR1.11, 95%CI, 0.56-2.20). PCI also independently predicted worsened DFS (HR1.12, 95%CI, 1.06-1.18) and OS (HR1.08, 95%CI, 1.04-1.12). Patients with unresectable disease had significantly worse OS (HR6.50, 95%CI, 1.37-7.01). CONCLUSIONS: CX after CRS + HIPEC significantly affect OS. Patient selection and perioperative care are of paramount importance in the management of CRS + HIPEC for colorectal PC.
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 Journal: Ann Surg Oncol Date: 2019-03-01 Impact factor: 5.344
Authors: Caroline J Rieser; Jurgis Alvikas; Heather Phelos; Lauren B Hall; Amer H Zureikat; Andrew Lee; Melanie Ongchin; Matthew P Holtzman; James F Pingpank; David L Bartlett; M Haroon A Choudry Journal: Ann Surg Oncol Date: 2022-01-06 Impact factor: 5.344
Authors: Tiffany C Lee; Koffi Wima; Jeffrey J Sussman; Syed A Ahmad; Jordan M Cloyd; Ahmed Ahmed; Keith Fournier; Andrew J Lee; Sean Dineen; Benjamin Powers; Jula Veerapong; Joel M Baumgartner; Callisia Clarke; Harveshp Mogal; Mohammad Y Zaidi; Shishir K Maithel; Jennifer Leiting; Travis Grotz; Laura Lambert; Ryan J Hendrix; Daniel E Abbott; Courtney Pokrzywa; Andrew M Blakely; Byrne Lee; Fabian M Johnston; Jonathan Greer; Sameer H Patel Journal: J Gastrointest Surg Date: 2019-11-19 Impact factor: 3.452
Authors: Caroline J Rieser; Richard S Hoehn; Mazen Zenati; Lauren B Hall; Eliza Kang; Amer H Zureikat; Andrew Lee; Melanie Ongchin; Matthew P Holtzman; James F Pingpank; David L Bartlett; M Haroon A Choudry Journal: Ann Surg Oncol Date: 2021-03-09 Impact factor: 5.344
Authors: Nicholas Brian Shannon; Joey Wee-Shan Tan; Hwee Leong Tan; Weining Wang; Yudong Chen; Hui Jun Lim; Qiu Xuan Tan; Josephine Hendrikson; Wai Har Ng; Li Yang Loo; Thakshayeni Skanthakumar; Seettha D Wasudevan; Oi Lian Kon; Tony Kiat Hon Lim; Grace Hwei Ching Tan; Claramae Shulyn Chia; Khee Chee Soo; Chin-Ann Johnny Ong; Melissa Ching Ching Teo Journal: Sci Rep Date: 2019-07-22 Impact factor: 4.379
Authors: Caroline J Rieser; Heather Jones; Lauren B Hall; Eliza Kang; Shannon Altpeter; Amer H Zureikat; Matthew P Holtzman; Andrew Lee; Melanie Ongchin; James F Pingpank; M Haroon A Choudry; David L Bartlett Journal: Ann Surg Oncol Date: 2021-07-05 Impact factor: 5.344