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. 2023 May;127(6):1028-1034.
doi: 10.1002/jso.27223. Epub 2023 Mar 2.

Incomplete cytoreductive surgery for appendiceal and colorectal peritoneal carcinomatosis: Characteristics and outcomes of an overlooked group

Paolo Goffredo  1 , Nicole Aguirre  1 , Mostafa Mohamed  1 , David A Kleiman  1 , Andrea Cercek  1 , J Joshua Smith  1 , Philip B Paty  1 , Martin Weiser  1 , Julio Garcia-Aguilar  1 , Garrett M Nash  1
Affiliations

Incomplete cytoreductive surgery for appendiceal and colorectal peritoneal carcinomatosis: Characteristics and outcomes of an overlooked group

Paolo Goffredo et al. J Surg Oncol. 2023 May.

Abstract

Background ond objectives: Complete cytoreductive surgery (CRS) may prolong survival for selected patients with peritoneal carcinomatosis from colorectal cancer (CRC). However, there is a paucity of data on outcomes following incomplete procedures.

Methods: Patients with incomplete CRS for well-differentiated (WD) and moderate/poorly-differentiated (M/PD) appendiceal cancer, right and left CRC were identified at a single tertiary center (2008-2021).

Results: Of 109 patients, 10% were WD and 51% M/PD appendiceal cancers, and 16% right and 23% left CRC. There were no differences in gender, BMI (mean = 27), ASA score, previous abdominal surgery (72%), and extent of CRS. The PC Index differed between appendiceal and colorectal cancers (mean = 27 vs. 17, p < 0.01). Overall, the perioperative outcomes were similar among the groups, with 15% experiencing complications. Postoperatively, 61% received chemotherapy, and 51% required ≥1 subsequent procedure. The 1 and 3-year survival for the WD, M/PD, right and left CRC subgroups were 100%, 67%, 44%, 51%, and 88%, 17%, 12%, and 23%, respectively (p = 0.02).

Conclusions: Incomplete CRS was associated with significant morbidity and number of subsequent palliative procedures. Prognosis correlated with histologic subtype; WD appendiceal cancer patients having superior outcomes, while those with right sided CRC the worst survival. These data may help guiding expectations in the setting of incomplete procedures.

Keywords: LAMN; complications; incomplete cytoreduction; metastatic colorectal cancer; outcomes.

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Figures

Figure 1.
Figure 1.
Overall survival by histologic subtype from day of surgery.
See this image and copyright information in PMC

References

    1. Elias D, Delperro JR, Sideris L, et al. Treatment of peritoneal carcinomatosis from colorectal cancer: impact of complete cytoreductive surgery and difficulties in conducting randomized trials. Annals of surgical oncology. 2004;11(5):518–521. - PubMed
    1. Dehal A, Smith JJ, Nash GM. Cytoreductive surgery and intraperitoneal chemotherapy: an evidence-based review-past, present and future. Journal of gastrointestinal oncology. 2016;7(1):143–157. - PMC - PubMed
    1. Quénet F, Elias D, Roca L, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial. The Lancet Oncology. 2021;22(2):256–266. - PubMed
    1. Dubé P, Sideris L, Law C, et al. Guidelines on the use of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal surface malignancy arising from colorectal or appendiceal neoplasms. Current oncology (Toronto, Ont). 2015;22(2):e100–112. - PMC - PubMed
    1. Elias D, Lefevre JH, Chevalier J, et al. Complete cytoreductive surgery plus intraperitoneal chemohyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2009;27(5):681–685. - PubMed