دورية أكاديمية
A novel preoperative risk score to optimize patient selection for performing concomitant liver resection with cytoreductive surgery/HIPEC
| العنوان: | A novel preoperative risk score to optimize patient selection for performing concomitant liver resection with cytoreductive surgery/HIPEC |
|---|---|
| المؤلفون: | Lee, Rachel M., Gamboa, Adriana C., Turgeon, Michael K., Zaidi, Mohammad Y., Kimbrough, Charles, Leiting, Jennifer, Grotz, Travis, Lee, Andrew J., Fournier, Keith, Powers, Benjamin, Dineen, Sean, Baumgartner, Joel M., Veerapong, Jula, Mogal, Harveshp, Clarke, Callisia, Wilson, Gregory, Patel, Sameer, Hendrix, Ryan, Lambert, Laura, Pokrzywa, Courtney, Abbott, Daniel E., LaRocca, Christopher J., Raoof, Mustafa, Greer, Jonathan, Johnston, Fabian M., Staley, Charles A., Cloyd, Jordan M., Maithel, Shishir K., Russell, Maria C. |
| المساهمون: | Surgery, School of Medicine |
| المصدر: | PMC |
| بيانات النشر: | Wiley |
| سنة النشر: | 2021 |
| المجموعة: | Indiana University - Purdue University Indianapolis: IUPUI Scholar Works |
| مصطلحات موضوعية: | Appendiceal adenocarcinoma, Colorectal cancer, HIPEC, Liver resection, Risk score |
| الوصف: | Background: While parenchymal hepatic metastases were previously considered a contraindication to cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC), liver resection (LR) is increasingly performed with CRS/HIPEC. Methods: Patients from the US HIPEC Collaborative (2000-2017) with invasive appendiceal or colorectal adenocarcinoma undergoing primary, curative intent CRS/HIPEC with CC0-1 resection were included. LR was defined as a formal parenchymal resection. Primary endpoints were postoperative complications and overall survival (OS). Results: A total of 658 patients were included. About 83 (15%) underwent LR of colorectal (58%) or invasive appendiceal (42%) metastases. LR patients had more complications (81% vs. 60%; p = .001), greater number of complications (2.3 vs. 1.5; p < .001) per patient and required more reoperations (22% vs. 11%; p = .007) and readmissions (39% vs. 25%; p = .014) than non-LR patients. LR patients had decreased OS (2-year OS 62% vs. 79%, p < .001), even when accounting for peritoneal carcinomatosis index and histology type. Preoperative factors associated with decreased OS on multivariable analysis in LR patients included age < 60 years (HR, 3.61; 95% CI, 1.10-11.81), colorectal histology (HR, 3.84; 95% CI, 1.69-12.65), and multiple liver tumors (HR, 3.45; 95% CI, 1.21-9.85) (all p < .05). When assigning one point for each factor, there was an incremental decrease in 2-year survival as the risk score increased from 0 to 3 (0: 100%; 1: 91%; 2: 58%; 3: 0%). Conclusions: As CRS/HIPEC + LR has become more common, we created a simple risk score to stratify patients considered for CRS/HIPEC + LR. These data aid in striking the balance between an increased perioperative complication profile with the potential for improvement in OS. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | Journal of Surgical Oncology; Lee RM, Gamboa AC, Turgeon MK, et al. A novel preoperative risk score to optimize patient selection for performing concomitant liver resection with cytoreductive surgery/HIPEC. J Surg Oncol. 2021;123(1):187-195. doi:10.1002/jso.26239; https://hdl.handle.net/1805/39077Test |
| الإتاحة: | https://doi.org/10.1002/jso.26239Test https://hdl.handle.net/1805/39077Test |
| حقوق: | Publisher Policy |
| رقم الانضمام: | edsbas.E19D2034 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |