Emmanuel Gabriel1, Smit Singla1, Minhyung Kim2, Daniel Fisher2, Colin Powers2, Anthony Visioni1, Kristopher Attwood3, Joseph Skitzki4. 1. Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA. 2. Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA. 3. Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA. 4. Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA. Electronic address: Joseph.Skitzki@RoswellPark.org.
Abstract
BACKGROUND: Water lavage (WL) during gastrointestinal cancer surgery has osmotically mediated lytic effects on tumor cells. We investigated the safety and efficacy of WL with CRS-HIPEC. METHODS: This is a retrospective review, 1/2003-7/2014, of a single institution experience with CRS-HIPEC comparing patients who had WL (WL+) to those who did not (WL-). RESULTS: Of 157 CRS-HIPECs, 16 (10.2%) were WL+. WL+ had more PCI scores >20 compared to WL- (56.3% vs 19.4%, respectively, p = 0.003); however, the completeness of cytoreduction (CC) was similar. There were no differences in hospital length of stay or post-operative complications. The average POD 1 sodium (Na) level was statistically lower in the WL+ group (133.6 ± 2.5 vs 135.5 ± 3.2 mEq/L, p = 0.023); however, the average Na at discharge for each group was 140 mEq/L. There were no differences in 3-year OS (3WL+:0.63 vs WL-:0.68, p = 0.97) or RFS (WL+:0.32 vs WL-:0.39, p = 0.47). A subset analysis for patients with PCI >20 showed no difference between groups. CONCLUSIONS: WL offers a low cost, safe and theoretically efficacious method of tumor cell lysis for peritoneal malignancy.
BACKGROUND:Water lavage (WL) during gastrointestinal cancer surgery has osmotically mediated lytic effects on tumor cells. We investigated the safety and efficacy of WL with CRS-HIPEC. METHODS: This is a retrospective review, 1/2003-7/2014, of a single institution experience with CRS-HIPEC comparing patients who had WL (WL+) to those who did not (WL-). RESULTS: Of 157 CRS-HIPECs, 16 (10.2%) were WL+. WL+ had more PCI scores >20 compared to WL- (56.3% vs 19.4%, respectively, p = 0.003); however, the completeness of cytoreduction (CC) was similar. There were no differences in hospital length of stay or post-operative complications. The average POD 1 sodium (Na) level was statistically lower in the WL+ group (133.6 ± 2.5 vs 135.5 ± 3.2 mEq/L, p = 0.023); however, the average Na at discharge for each group was 140 mEq/L. There were no differences in 3-year OS (3WL+:0.63 vs WL-:0.68, p = 0.97) or RFS (WL+:0.32 vs WL-:0.39, p = 0.47). A subset analysis for patients with PCI >20 showed no difference between groups. CONCLUSIONS: WL offers a low cost, safe and theoretically efficacious method of tumor cell lysis for peritoneal malignancy.
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