Long-term Survival and Propensity Score Matched Outcomes of Bilateral
| Autor: | Bhavneet, Singh, Gurkirat, Singh, Mohammad, Pourgholami, Nayef, Alzahrani, David L, Morris |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Aged 80 and over Male Adolescent Diaphragm Cytoreduction Surgical Procedures Hyperthermia Induced Middle Aged Prognosis Adenocarcinoma Mucinous Combined Modality Therapy Survival Rate Young Adult Appendiceal Neoplasms Chemotherapy Adjuvant Chemotherapy Cancer Regional Perfusion Humans Female Colorectal Neoplasms Propensity Score Peritoneal Neoplasms Aged Follow-Up Studies Retrospective Studies |
| Zdroj: | Anticancer research. 38(10) |
| ISSN: | 1791-7530 |
| Popis: | To assess the impact of short- and long-term outcomes of bilateral vs. unilateral diaphragm interventions in cyto-reductive surgery (CRS) and intra-peritoneal chemotherapy (IPC).A total of 652 CRS/IPC procedures, between 1996 and 2018, required diaphragm interventions. Among these, 388 underwent bilateral intervention. Preoperative heterogeneity was assessed in 6 parameters and addressed with propensity score matching. The association of each respective analysis was assessed with 11 outcomes. Overall survival was assessed based on histology.CRS/IPC requiring bilateral diaphragmatic interventions illustrated significantly increased operative hours (9.6 vs. 8.6 hours, p0.001). Postoperatively, there was significantly increased red blood cell (RBC) transfusion (6.37 units vs. 4.47 units, p=0.007) and grade III and IV complications (57.3% vs. 40.6%, p=0.004). No difference was noted in ICU stay, total length of stay, hospital death and return to OT. In terms of respiratory complications, an increased incidence of pneumothorax (16.5% vs. 6.2%, p0.001) was noted whilst pleural effusions and pneumonia occurrences were non-significant. Overall survival, revealed bilateral interventions in low-grade appendiceal mucinous neoplasm conferred an increased relative risk (p=0.037, RR=2.230, 95%CI=1.052-4.730). They did not have an effect on OS in colorectal cancer and mesothelioma.Despite the increase in short-term morbidity, bilateral diaphragm interventions resulted in similar long-term survival to unilateral interventions. |
| Databáze: | OpenAIRE |
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