BACKGROUND: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) used to treat peritoneal surface disease (PSD) from @entity5 have shown variability in survival outcomes. The primary goal of this study was to determine predictors of surgical morbidity and overall survival. The secondary goal was to describe the impact of nodal status on survival after CRS/HIPEC for PSD from low-grade appendiceal (LGA) and high-grade appendiceal (HGA) primary lesions. METHODS: A retrospective analysis of 1,069 procedures from a prospective database was performed. @entity1 characteristics, @entity5 grade, nodal status, performance status, resection status, morbidity, mortality, and survival were reviewed. RESULTS: The study identified 481 CRS/HIPEC procedures: 317 (77.3 %) for LGA and 93 (22.7 %) for HGA lesions. The median follow-up period was 44.4 months, and the 30-day major morbidity and mortality rates were respectively 27.8 and 2.7 %. Major morbidity was jointly predicted by incomplete cytoreduction (p = 0.0037), involved nodes (p < 0.0001), and comorbidities (p = 0.003). Multivariate negative predictors of survival included positive nodal status (p = 0.003), incomplete cytoreduction (p < 0.0001), and preoperative chemotherapy (p = 0.04) in LGA @entity1 and incomplete cytoreduction (p = 0.0003) and preoperative chemotherapy (p = 0.0064) in HGA @entity1 . After complete cytoreduction, median survival was worse for @entity1 with positive nodes than for those with negative nodes in LGA (85 months vs not reached [82 % alive at 90 months]; p = 0.002) and HGA (30 vs 153 months; p < 0.0001). CONCLUSIONS: Positive nodes are associated with decreased survival not only for HGA @entity1 but also for LGA @entity1 even after complete cytoreduction. Nodal status further stratifies histologic grade as a prognostic indicator of survival. @entity1 with node-negative HGA primary lesions who receive a complete cytoreduction may experience survival comparable with that for LGA @entity1 .

Peritoneal surface disease (PSD) from XXXX treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC): overview of 481 cases.

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'appendiceal cancer'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'Patient']
@entity5 :: (MESH:D009369,Disease) :: ['appendiceal cancer']
