التفاصيل البيبلوغرافية
| 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 |
| المصدر: |
Journal of Surgical Oncology, vol 123, iss 1 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2021 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Clinical Research, Digestive Diseases, Liver Disease, Patient Safety, Colo-Rectal Cancer, Cancer, Evaluation of treatments and therapeutic interventions, 6.4 Surgery, Appendiceal Neoplasms, Chemotherapy, Regional Perfusion, Colorectal Neoplasms, Combined Modality Therapy, Cytoreduction Surgical Procedures, Female, Follow-Up Studies, Hepatectomy, Humans, Hyperthermia, Induced, Male, Middle Aged, Patient Selection, Peritoneal Neoplasms, Preoperative Care, Prognosis, Risk Factors, Survival Rate, appendiceal adenocarcinoma, colorectal cancer |
| جغرافية الموضوع: |
187 - 195 |
| الوصف: |
BackgroundWhile 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.MethodsPatients 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).ResultsA 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%).ConclusionsAs 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: |
unknown |
| العلاقة: |
qt3sk5x02x; https://escholarship.org/uc/item/3sk5x02xTest |
| الإتاحة: |
https://escholarship.org/uc/item/3sk5x02xTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.C688F038 |
| قاعدة البيانات: |
BASE |
