The impact of surgical staging in patients with colorectal peritoneal metastases scheduled for CRS-HIPEC.

IF 2.4 Q4 ONCOLOGY
Pleura and Peritoneum Pub Date : 2025-04-28 eCollection Date: 2025-06-01 DOI:10.1515/pp-2024-0013
Lana Ghanipour, Johan Wallin, Peter Cashin, Wilhelm Graf
{"title":"The impact of surgical staging in patients with colorectal peritoneal metastases scheduled for CRS-HIPEC.","authors":"Lana Ghanipour, Johan Wallin, Peter Cashin, Wilhelm Graf","doi":"10.1515/pp-2024-0013","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Surgical staging procedures are used to select patients with peritoneal metastases for surgery. We aimed to evaluate the impact of surgical staging procedures and the risk of abdominal wall recurrences in patients with peritoneal metastases scheduled for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).</p><p><strong>Methods: </strong>Data were collected from a prospective maintained HIPEC register January 2012-December 2019. Patients with colorectal peritoneal metastases were included. Information about surgical staging procedures was registered. Results were then compared with those registered at definite CRS-HIPEC surgery and survival was analysed in relation to surgical staging procedures.</p><p><strong>Results: </strong>In total, 138 patients were included, of whom 32 had undergone a surgical staging procedure before CRS-HIPEC. Median overall survival in the surgical staging group was 1.89 years and in the non-staging group 3.07 years (p=0.060). In the surgical staging group, eight patients developed abdominal wall recurrences (25 %) compared with three (3 %) in the non-staged group. Eight staged patients (25 %) were considered inoperable at definite surgery (open-close). PCI score (p<0.001) was higher at definite surgery in patients who had undergone a staging laparoscopy. Factors associated with shorter overall survival in multivariate analysis were: open and close, PCI ≥21 and presence of signet ring cells. However, a staging procedure was not associated with a shorter overall survival.</p><p><strong>Conclusions: </strong>Surgical staging procedures is a valuable assessment of inoperability, though at the expense of more frequent abdominal wall recurrences. Imaging-based strategies may provide useful insights into whether surgical staging is the most effective approach for patient selection.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"10 2","pages":"59-68"},"PeriodicalIF":2.4000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207389/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pleura and Peritoneum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1515/pp-2024-0013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: Surgical staging procedures are used to select patients with peritoneal metastases for surgery. We aimed to evaluate the impact of surgical staging procedures and the risk of abdominal wall recurrences in patients with peritoneal metastases scheduled for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).

Methods: Data were collected from a prospective maintained HIPEC register January 2012-December 2019. Patients with colorectal peritoneal metastases were included. Information about surgical staging procedures was registered. Results were then compared with those registered at definite CRS-HIPEC surgery and survival was analysed in relation to surgical staging procedures.

Results: In total, 138 patients were included, of whom 32 had undergone a surgical staging procedure before CRS-HIPEC. Median overall survival in the surgical staging group was 1.89 years and in the non-staging group 3.07 years (p=0.060). In the surgical staging group, eight patients developed abdominal wall recurrences (25 %) compared with three (3 %) in the non-staged group. Eight staged patients (25 %) were considered inoperable at definite surgery (open-close). PCI score (p<0.001) was higher at definite surgery in patients who had undergone a staging laparoscopy. Factors associated with shorter overall survival in multivariate analysis were: open and close, PCI ≥21 and presence of signet ring cells. However, a staging procedure was not associated with a shorter overall survival.

Conclusions: Surgical staging procedures is a valuable assessment of inoperability, though at the expense of more frequent abdominal wall recurrences. Imaging-based strategies may provide useful insights into whether surgical staging is the most effective approach for patient selection.

CRS-HIPEC计划结肠直肠腹膜转移患者手术分期的影响。
目的:手术分期程序用于选择腹膜转移患者进行手术。我们的目的是评估手术分期和腹膜转移患者腹壁复发风险的影响,这些患者计划进行细胞减少手术和腹腔内高温化疗(CRS-HIPEC)。方法:数据收集自2012年1月至2019年12月的前瞻性维持HIPEC登记册。包括结直肠腹膜转移的患者。登记有关手术分期程序的信息。然后将结果与明确的CRS-HIPEC手术记录的结果进行比较,并分析与手术分期程序相关的生存率。结果:共纳入138例患者,其中32例在CRS-HIPEC前进行了手术分期。手术分期组的中位总生存期为1.89年,非分期组的中位总生存期为3.07年(p=0.060)。在手术分期组中,8例患者出现腹壁复发(25 %),而非分期组中有3例(3 %)。8例分期患者(25 %)在确定手术(开合)时被认为不能手术。结论:手术分期是一种有价值的评估不操作性的方法,尽管代价是腹壁复发的频率更高。基于影像的策略可以为手术分期是否是患者选择的最有效方法提供有用的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.50
自引率
11.10%
发文量
23
审稿时长
9 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信