Yeqian Huang1, Nayef A Alzahrani2, Oliver M Fisher1, Terence C Chua3, Mathew A Kozman1, Winston Liauw4, Arief Arrowaili5, Sarah J Valle1, David L Morris6. 1. Department of Surgery, St George Hospital, New South Wales, University of New South Wales, Australia. 2. Department of Surgery, St George Hospital, New South Wales, University of New South Wales, Australia; College of Medicine, Al Imam Muhammad lbn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia. 3. Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia. 4. Cancer Care Centre, St George Hospital, Sydney, New South Wales Australia. 5. College of Medicine, Al Imam Muhammad lbn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia. 6. Department of Surgery, St George Hospital, New South Wales, University of New South Wales, Australia. Electronic address: david.morris@unsw.edu.au.
Abstract
BACKGROUND: This study examines the impact of intraoperative macroscopic tumour consistency on short-term and long-term outcomes after cytoreductive surgery (CRS) with intraperitoneal chemotherapy (IPC) for appendiceal adenocarcinoma with peritoneal metastases. METHODS: Macroscopic intraoperative tumour consistency was classified in three groups as soft (jelly-like geltatinous tumours), hard (hard tumour nodules without gelatinous features) and intermediate (both soft and hard features). In-hospital mortality, major morbidity, intensive care unit (ICU), high dependency unit (HDU) and total hospital stay, disease-free survival (DFS) and overall survival (OS) were compared. RESULTS: The three groups had similar perioperative short-term outcomes. Patients with soft, intermediate and hard tumours revealed differences in OS (p < 0.001) and DFS (p = 0.03). Multivariable analysis revealed a shorter OS for patients with hard versus soft tumours (HR for hard tumours = 4.43, 95%CI 2.19-9.00). CONCLUSIONS: Intraoperative macroscopic tumour consistency may be used as a prognostic marker for survival in patients with appendiceal adenocarcinoma with peritoneal metastases.
BACKGROUND: This study examines the impact of intraoperative macroscopic tumour consistency on short-term and long-term outcomes after cytoreductive surgery (CRS) with intraperitoneal chemotherapy (IPC) for appendiceal adenocarcinoma with peritoneal metastases. METHODS: Macroscopic intraoperative tumour consistency was classified in three groups as soft (jelly-like geltatinous tumours), hard (hard tumour nodules without gelatinous features) and intermediate (both soft and hard features). In-hospital mortality, major morbidity, intensive care unit (ICU), high dependency unit (HDU) and total hospital stay, disease-free survival (DFS) and overall survival (OS) were compared. RESULTS: The three groups had similar perioperative short-term outcomes. Patients with soft, intermediate and hard tumours revealed differences in OS (p < 0.001) and DFS (p = 0.03). Multivariable analysis revealed a shorter OS for patients with hard versus soft tumours (HR for hard tumours = 4.43, 95%CI 2.19-9.00). CONCLUSIONS: Intraoperative macroscopic tumour consistency may be used as a prognostic marker for survival in patients with appendiceal adenocarcinoma with peritoneal metastases.