David Roife1,2, Benjamin D Powers1,2, Mohammad Y Zaidi3, Charles A Staley3, Jordan M Cloyd4, Ahmed Ahmed4, Travis Grotz5, Jennifer Leiting5, Keith Fournier6, Andrew J Lee6, Jula Veerapong7, Joel M Baumgartner7, Callisia Clarke8, Sameer H Patel9, Ryan J Hendrix10, Laura Lambert11, Daniel E Abbott12, Courtney Pokrzywa12, Byrne Lee13, Andrew Blakely13, Jonathan Greer14, Fabian M Johnston14, Danielle Laskowitz1, Sophie Dessureault1,2, Sean P Dineen15,16. 1. Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA. 2. Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, Tampa, USA. 3. Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, USA. 4. Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, USA. 5. Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, USA. 6. Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. 7. Division of Surgical Oncology, Department of Surgery, University of California, San Diego, USA. 8. Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, USA. 9. Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, USA. 10. Division of Surgical Oncology, Department of Surgery, University of Massachusetts Medical School, Worcester, USA. 11. Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA. 12. Division of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, USA. 13. Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, USA. 14. Department of Surgery, Johns Hopkins University, Baltimore, MD, USA. 15. Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA. sean.dineen@moffitt.org. 16. Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, Tampa, USA. sean.dineen@moffitt.org.
Abstract
INTRODUCTION: CRS/HIPEC is thought to confer a survival advantage for patients with malignant peritoneal mesothelioma (MPM). However, the impact of nonperitoneal organ resection is not clearly defined. We evaluated the impact of major organ resection (MOR) on postoperative outcomes and overall survival (OS). PATIENTS AND METHODS: The US HIPEC collaborative database (2000-2017) was reviewed for MPM patients who underwent CRS/HIPEC. MOR was defined as total or partial resection of diaphragm, stomach, spleen, pancreas, small bowel, colon, rectum, kidney, ureter, bladder, and/or uterus. MOR was categorized as 0, 1, or 2+ organs. RESULTS: A total of 174 patients were identified. Median PCI was 16 (3-39). The distribution of patients with MOR-0, MOR-1, and MOR-2+ was 94, 45, and 35 patients, respectively. MOR-1 and MOR-2+ groups had a higher frequency of any complication compared with MOR-0 (57.8%, 74.3%, and 48.9%, respectively, p = 0.035), but Clavien 3/4 complications were similar. Median length of stay was slightly higher in the MOR-1 and MOR-2+ groups (10 and 11 days) compared with the MOR-0 cohort (9 days, p = 0.005). Incomplete cytoreduction, ASA class 4, and male gender were associated with increased mortality on unadjusted analysis; however, their impact on OS was attenuated on multivariable analysis. MOR was not associated with OS based on these data (MOR-1: HR 1.67, 95% CI 0.59-4.74; MOR-2+ : HR 0.77, 95% CI 0.22-2.69). CONCLUSIONS: MOR was not associated with an increase in major complications or worse OS in patients undergoing CRS/HIPEC for MPM and should be considered, if necessary, to achieve complete cytoreduction for MPM patients.
INTRODUCTION:CRS/HIPEC is thought to confer a survival advantage for patients with malignant peritoneal mesothelioma (MPM). However, the impact of nonperitoneal organ resection is not clearly defined. We evaluated the impact of major organ resection (MOR) on postoperative outcomes and overall survival (OS). PATIENTS AND METHODS: The US HIPEC collaborative database (2000-2017) was reviewed for MPM patients who underwent CRS/HIPEC. MOR was defined as total or partial resection of diaphragm, stomach, spleen, pancreas, small bowel, colon, rectum, kidney, ureter, bladder, and/or uterus. MOR was categorized as 0, 1, or 2+ organs. RESULTS: A total of 174 patients were identified. Median PCI was 16 (3-39). The distribution of patients with MOR-0, MOR-1, and MOR-2+ was 94, 45, and 35 patients, respectively. MOR-1 and MOR-2+ groups had a higher frequency of any complication compared with MOR-0 (57.8%, 74.3%, and 48.9%, respectively, p = 0.035), but Clavien 3/4 complications were similar. Median length of stay was slightly higher in the MOR-1 and MOR-2+ groups (10 and 11 days) compared with the MOR-0 cohort (9 days, p = 0.005). Incomplete cytoreduction, ASA class 4, and male gender were associated with increased mortality on unadjusted analysis; however, their impact on OS was attenuated on multivariable analysis. MOR was not associated with OS based on these data (MOR-1: HR 1.67, 95% CI 0.59-4.74; MOR-2+ : HR 0.77, 95% CI 0.22-2.69). CONCLUSIONS: MOR was not associated with an increase in major complications or worse OS in patients undergoing CRS/HIPEC for MPM and should be considered, if necessary, to achieve complete cytoreduction for MPM patients.
Authors: David Roife; Benjamin D Powers; Mohammad Y Zaidi; Charles A Staley; Jordan M Cloyd; Ahmed Ahmed; Travis Grotz; Jennifer Leiting; Keith Fournier; Andrew J Lee; Jula Veerapong; Joel M Baumgartner; Callisia Clarke; Sameer H Patel; Ryan J Hendrix; Laura Lambert; Daniel E Abbott; Courtney Pokrzywa; Byrne Lee; Andrew Blakely; Jonathan Greer; Fabian M Johnston; Danielle Laskowitz; Sophie Dessureault; Sean P Dineen Journal: Ann Surg Oncol Date: 2020-10-18 Impact factor: 5.344
Authors: David Roife; Benjamin D Powers; Mohammad Y Zaidi; Charles A Staley; Jordan M Cloyd; Ahmed Ahmed; Travis Grotz; Jennifer Leiting; Keith Fournier; Andrew J Lee; Jula Veerapong; Joel M Baumgartner; Callisia Clarke; Sameer H Patel; Ryan J Hendrix; Laura Lambert; Daniel E Abbott; Courtney Pokrzywa; Byrne Lee; Andrew Blakely; Jonathan Greer; Fabian M Johnston; Danielle Laskowitz; Sophie Dessureault; Sean P Dineen Journal: Ann Surg Oncol Date: 2020-10-18 Impact factor: 5.344
Authors: Can Yurttas; Lisa Überrück; Giorgi Nadiradze; Alfred Königsrainer; Philipp Horvath Journal: Langenbecks Arch Surg Date: 2022-02-02 Impact factor: 2.895