In Patients Undergoing CRS/HIPEC for Colorectal Adenocarcinoma with Peritoneal Metastases, Presence of Ascites on Computed Tomography Imaging is not a Prognostic Marker for Survival
| Autor: | Ibrahim, Said, Inge, Ubink, Roos S G, Ewalds, Johanna G T, Arkesteijn, Henk M W, Verheul, Johannes H W, de Wilt, Helena M, Dekker, Andreas J A, Bremers, Philip R, de Reuver |
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| Rok vydání: | 2021 |
| Předmět: |
Ascites
Cytoreduction Surgical Procedures Hyperthermia Induced Hyperthermic Intraperitoneal Chemotherapy Adenocarcinoma Prognosis Combined Modality Therapy Survival Rate Chemotherapy Cancer Regional Perfusion Humans Colorectal Neoplasms Tomography X-Ray Computed Tomography Peritoneal Neoplasms Retrospective Studies |
| Zdroj: | Annals of surgical oncology. 29(8) |
| ISSN: | 1534-4681 |
| Popis: | Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a potentially curative treatment for patients with colorectal peritoneal metastases (CRPM). Patient selection is key to optimizing outcomes after CRS/HIPEC. The aim of this study was to determine the prognostic value of ascites diagnosed on preoperative imaging.A prospective database of patients eligible for CRS/HIPEC between 2010 and 2020 was retrospectively analyzed. The presence of ascites, postoperative complications, overall survival (OS), disease-free survival (DFS), and completeness of cytoreduction were assessed. Univariable and multivariable logistic regression was performed to identify independent predictors for outcome.Of the 235 included patients, 177 (75%) underwent CRS/HIPEC while 58 (25%) were not eligible for CRS/HIPEC. In 42 of the 177 patients (24%) who underwent CRS/HIPEC, ascites was present on preoperative computed tomography (CT) imaging. Peritoneal Cancer Index (PCI) score was significantly higher in patients with preoperative ascites compared with patients without (11 [range 2-30] vs. 9 [range 0-28], respectively; p = 0.011) and complete cytoreduction was more often achieved in patients without ascites (96.3% vs. 85.7%; p = 0.007). There was no significant difference in median DFS and OS after CRS/HIPEC between patients with and without ascites {10 months (95% confidence interval [CI] 7.1-12.9) vs. 9 months (95% CI 7.2-10.8), and 25 months (95% 9.4-40.6) vs. 27 months (95% CI 22.4-31.6), respectively}.Ascites on preoperative imaging was not associated with worse survival in CRS/HIPEC patients with CRPM. Therefore, excluding patients from CRS/HIPEC based merely on the presence of ascites is not advisable. |
| Databáze: | OpenAIRE |
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