Ejso最新文献

{"title":"Patient public perspectives on digital colorectal cancer surgery (DALLAS).","authors":"Deirdre M Nally, Emma C Kearns, Jeffrey Dalli, Niamh Moynagh, Kate Hanley, Peter Neary, Ronan A Cahill","doi":"10.1016/j.ejso.2024.108705","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108705","url":null,"abstract":"<p><strong>Introduction: </strong>The importance of patient perspectives is increasingly appreciated in clinical practice and academia with formal engagement processes developing worldwide. Digital surgery encompasses intraoperative patient data (including surgical video) analysis and so requires public-patient involvement (PPI).</p><p><strong>Methods: </strong>Engagement events were conducted based on NIHR and GRIPP2 LF guidelines. Following informative talks on digital surgery, invited patients and patient relatives were split into focus groups regarding 1) Research; 2) Data; 3) Industry Involvement; and 4) Artificial Intelligence in surgery. Scribed feedback was thematically analysed by two researchers independently. A pre and post event survey was sought voluntarily.</p><p><strong>Results: </strong>36 participant perspectives were analysed. In general, patients were enthusiastic about having a voice in surgical research and sharing their journey, with most groups concluding that capturing this was most appropriate after treatment recovery. The use of patient data for surgical development (i.e. research and education) was endorsed unanimously for the purpose of future patient benefit when responsibly and transparently managed and the value of industry was acknowledged. From 30 pre/post surveys (all p > 0.05), participants afforded the greatest data (including video) ownership claim to the surgical team (52 %/48 %) versus patients (32 %/24 %) and the hospital (12 %/24 %). While most (73 %/80 %) agreed that AI should be applied in surgical care, most felt the surgeon most valuable (93 %/80 %) with participants disagreeing that AI should make diagnoses (57 %/64 %) or treat patients (70 %/70 %) without human input.</p><p><strong>Conclusion: </strong>Patients capably represent stable views and expectations that can strengthen modern and evolving surgical development involving data privacy, ownership and management.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"108705"},"PeriodicalIF":3.5,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing vulvar cancer care: Integrating biomarkers and AI for better outcomes.","authors":"Hanzala Ahmed Farooqi, Hamza Bin Ahmed, Rayyan Nabi","doi":"10.1016/j.ejso.2024.108776","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108776","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"108776"},"PeriodicalIF":3.5,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the advanced lung cancer inflammation index in intrahepatic cholangiocarcinoma","authors":"Giovanni Catalano ,&nbsp;Laura Alaimo ,&nbsp;Odysseas P. Chatzipanagiotou ,&nbsp;Andrea Ruzzenente ,&nbsp;Federico Aucejo ,&nbsp;Hugo P. Marques ,&nbsp;Vincent Lam ,&nbsp;Tom Hugh ,&nbsp;Nazim Bhimani ,&nbsp;Shishir K. Maithel ,&nbsp;Minoru Kitago ,&nbsp;Itaru Endo ,&nbsp;Guillaume Martel ,&nbsp;Carlo Pulitano ,&nbsp;Feng Shen ,&nbsp;Irinel Popescu ,&nbsp;Bas Groot Koerkamp ,&nbsp;Todd W. Bauer ,&nbsp;François Cauchy ,&nbsp;George A. Poultsides ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.ejso.2024.108773","DOIUrl":"10.1016/j.ejso.2024.108773","url":null,"abstract":"<div><h3>Introduction</h3><div>The advanced lung cancer inflammation index (ALI), which combines inflammation and nutrition data, was recently proposed as a prognostic biomarker. We assessed the impact of ALI on overall survival (OS) among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC).</div></div><div><h3>Methods</h3><div>Patients who underwent surgery for ICC were identified from an international cohort. ALI was calculated as body-mass index (BMI)∗albumin/neutrophil-to-lymphocyte ratio; patients were categorized into “low-” and “high-ALI” using log-rank statistics. The impact of ALI on OS was compared against other inflammatory markers (i.e., neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune inflammation index [SII = platelets∗NLR]) using Harrell's Concordance index (C-index) and the Akaike Information Criterion (AIC). To minimize intergroup differences, propensity score matching was employed.</div></div><div><h3>Results</h3><div>Among 1045 patients, more than one-half of individuals underwent major hepatectomy (n = 582, 55.7 %), median tumor size was 5.5 cm (IQR, 3.8–7.8), and median ALI was 38.9 (IQR 26.5–57.2). On multivariate analysis, low ALI was an independent risk factor for worse OS (HR 1.21, 95 % CI 1.01–1.46; p = 0.04). Patients with low ALI had worse 5-year OS (36.9 % vs. 49.9 %; p &lt; 0.001), which remained significant after PSM (36.9 % vs. 41.3 %; p = 0.039). ALI had a comparable discriminatory ability compared with NLR, PLR, and SII (C-index: 0.646 vs. 0.644 vs. 0.640 vs. 0.641, respectively), yet had a lower AIC (5475.31 vs. 5546.80 vs. 5550.45 vs. 5548.62, respectively) suggesting slightly better model fit and accuracy.</div></div><div><h3>Conclusions</h3><div>ALI was an independent predictor of OS among patients undergoing surgery for ICC. Nutritional and inflammatory markers should be incorporated into predictive models to improve prognostic stratification.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"50 12","pages":"Article 108773"},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of sarcopenic obesity in patients with gastric cancer and effects on adverse outcomes: A meta-analysis and systematic review","authors":"Bingyan Zhao ,&nbsp;Leilei Bao ,&nbsp;Tongyu Zhang ,&nbsp;Yu Chen ,&nbsp;Siai Zhang ,&nbsp;Chunmei Zhang","doi":"10.1016/j.ejso.2024.108772","DOIUrl":"10.1016/j.ejso.2024.108772","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the prevalence of sarcopenic obesity in patients with gastric cancer and its impact on adverse outcomes.</div></div><div><h3>Methods</h3><div>A computerized search of PubMed, Embase, Cochrane Library, Web of Science, and CINAHL databases was performed to search for articles related to sarcopenic obesity in patients with gastric cancer. The search was conducted until June 16, 2024, from the date of the creation of the database.</div></div><div><h3>Results</h3><div>A total of sixteen studies were included, including fifteen cohort studies and one cross-sectional study involving 4087 patients. The results of the meta-analysis showed that the prevalence of sarcopenic obesity in gastric cancer patients was 16.3 % (95 % CI: 12.2 %–20.4 %). Sarcopenic obesity significantly shortened the overall survival of gastric cancer patients (HR = 1.64, 95 % CI: 1.20 to 2.25, <em>P</em> = 0.002) and increased the risk of postoperative significant complications (OR = 2.84, 95 % CI: 1.95 to 4.16, <em>P</em> &lt; 0.001), severe complications (OR = 2.60, 95 % CI: 1.45 to 4.64, <em>P</em> = 0.001), surgical site infection (OR = 3.82, 95 % CI: 1.47 to 9.89, <em>P</em> = 0.006), and mortality (OR = 4.84, 95 % CI: 1.38 to 17.02, <em>P</em> = 0.014), but no significant effect on 30-day readmission (OR = 1.90, 95 % CI: 0.31 to 11.84, <em>P</em> = 0.491).</div></div><div><h3>Conclusions</h3><div>The prevalence of sarcopenic obesity is high in patients with gastric cancer and is strongly associated with poor postoperative outcomes. Healthcare providers should evaluate patients with gastric cancer for sarcopenic obesity early to prevent or reduce the incidence of adverse outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"50 12","pages":"Article 108772"},"PeriodicalIF":3.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel multimodal sensing and machine learning strategies to classify cognitive workload in laparoscopic surgery.","authors":"Ravi Naik, Adrian Rubio-Solis, Kaizhe Jin, George Mylonas","doi":"10.1016/j.ejso.2024.108735","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108735","url":null,"abstract":"<p><strong>Background: </strong>Surgeons can experience elevated cognitive workload (CWL) during surgery due to various factors including operative technicalities and the environmental demands of the operating theatre. This can result in poorer outcomes and have a detrimental effect on surgeon well-being. The objective measurement of CWL provides a potential solution to facilitate classification of workload levels, however results are variable when physiological measures are used in isolation. The aim of this study is to develop and propose a multimodal machine learning (ML) approach to classify CWL levels using a bespoke sensor platform and to develop a ML approach to impute missing pupil diameter measures due to the effect of blinking or noise.</p><p><strong>Materials and methods: </strong>Ten surgical trainees performed a simulated laparoscopic cholecystectomy under cognitive conditions of increasing difficulty, namely a modified auditory N-back task with increasing difficulty and a verbal clinical scenario. Physiological measures were recorded using a novel platform (MAESTRO). Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) were used as direct measures of CWL. Indirect measures included electromyography (EMG), electrocardiography (ECG) and pupil diameter (PD). A reference point for validation was provided by subjective assessment of perceived CWL using the SURG-TLX. A multimodal machine learning approach that systematically implements a CNN-BiLSTM, a binary version of the metaheuristic Manta Ray Foraging Optimisation (BMRFO) and a version of Fuzzy C-Means (FCM) called Optimal Completion Strategy (OCS) was used to classify the associated perceived CWL state.</p><p><strong>Results: </strong>Compared to other state of the art classification techniques, cross-validation results for the classification of CWL levels suggest that the CNN-BLSTM and BMRFO approach provides an average accuracy of 97 % based on the confusion matrix. Additionally, OCS demonstrated a superior average performance of 9.15 % in terms of Root-Mean-Square-Error (RMSE) when compared to other PD imputation methods.</p><p><strong>Conclusion: </strong>Perceived CWL levels were correctly classified using a multimodal ML approach. This approach provides a potential route to accurately classify CWL levels, which may have application in future surgical training and assessment programs as well as the development of cognitive support systems in the operating room.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"108735"},"PeriodicalIF":3.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for major complications following pelvic exenteration: A NSQIP study","authors":"Gabriel Levin ,&nbsp;Brian Slomovitz ,&nbsp;Jason D. Wright ,&nbsp;Rene Pareja ,&nbsp;Kacey M. Hamilton ,&nbsp;Rebecca schneyer ,&nbsp;Matthew T. Siedhoff ,&nbsp;Kelly N. Wright ,&nbsp;Yosef Nasseri ,&nbsp;Moshe Barnajian ,&nbsp;Raanan Meyer","doi":"10.1016/j.ejso.2024.108761","DOIUrl":"10.1016/j.ejso.2024.108761","url":null,"abstract":"<div><h3>Objectives</h3><div>Due to the rarity of pelvic exenteration surgery, it is challenging to predict which patients are at an increased risk for postoperative complications. We aimed to study the predictors for postoperative complications among women undergoing pelvic exenteration for gynecologic malignancy.</div></div><div><h3>Method</h3><div>We used the National Surgical Quality Improvement Program registry to evaluate postoperative course and complications of those patients undergoing pelvic exenteration in the period 2012–2022. The primary objective of the analysis was to estimate the major postoperative complications following pelvic exenteration.</div></div><div><h3>Results</h3><div>Overall, 794 pelvic exenterations were included. Of those, 56.5 % were anterior exenteration, 43.5 % were posterior exenteration, and 13.9 % were a combined exenteration. The rate of minor complications was 72.5 % (n = 576), and the rate of major complications was 31.5 % (n = 250). The most common minor complications were blood transfusion (n = 538, 67.8 %), followed by superficial surgical site infections (SSI) and urinary tract infections (9.8 % and 9.4 %, respectively). Among the major complications, the most common was organ/space SSI (11.2 %), followed by sepsis (9.2 %), reoperation (8.6 %), and wound dehiscence (5.2 %). Death within 30 days occurred in 1.5 % of patients. In multivariable regression analysis, the following factors were independently associated with major complications: higher BMI [adjusted odds ratio (aOR) 1.03 95 % confidence interval (CI) (1.01–1.05)], diabetes [aOR 1.82 95 % CI (1.13–3.22)], low serum albumin [aOR 0.73 95 % CI (0.54–0.98)], and high serum creatinine [aOR 1.70 95 % CI (1.05–2.77)].</div></div><div><h3>Conclusions</h3><div>Major postoperative complications occur in approximately one third of pelvic exenterations for gynecologic malignancies. Our study highlights independent factors associated with major postoperative complications, of which some are potentially modifiable.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"50 12","pages":"Article 108761"},"PeriodicalIF":3.5,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of preoperative weight loss interventions on postoperative outcomes for patients with gastrointestinal cancer","authors":"Yangyue Zhang ,&nbsp;Natalia Tomborelli Bellafronte ,&nbsp;Gezal Najafitirehshabankareh ,&nbsp;Michelle Huamani Jimenez ,&nbsp;Emily Jaeger-McEnroe ,&nbsp;Hughes Plourde ,&nbsp;Mary Hendrickson ,&nbsp;Chelsia Gillis","doi":"10.1016/j.ejso.2024.108743","DOIUrl":"10.1016/j.ejso.2024.108743","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is associated with increased risk of surgical complications in some settings.</div></div><div><h3>Objective</h3><div>As a precursor to a systematic review, we conducted a scoping review of intentional preoperative weight loss to describe these interventions, their feasibility and effectiveness for patients with gastrointestinal cancer.</div></div><div><h3>Methods</h3><div>In April 2024, Ovid MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for primary studies of intentional weight loss before elective gastrointestinal cancer surgery. Extracted data encompassed recruitment and attrition, intervention types, adherence, anthropometric and body composition changes, and surgical outcomes. Study quality was assessed using the Risk of Bias In Non-randomized Studies of Interventions tool.</div></div><div><h3>Results</h3><div>The search produced 7 articles (4 non-randomized clinical trials), which were all conducted in Japan, and involved 258 participants with a baseline BMI ≥25 kg/m². Weight loss interventions included dietary modification (n = 3), exercise (n = 1), and combination (n = 3). None of the articles reported rates of recruitment, 2 adherence (97–100 %), and 4 reported attrition rates (0–18 %). All reported weight reductions of −1.3 to −6 kg and 4.5–6.9 % (n = 7), compared to baseline. Three of four non-randomized trials observed a reduction in postoperative complications, as compared to control; yet all trials were at critical risk of bias.</div></div><div><h3>Conclusion</h3><div>Strong conclusions could not be made due to the limited reporting and critical risk of bias; further systematic review is not recommended at this time. To establish more robust evidence, there is a clear need for high-quality trials.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"50 12","pages":"Article 108743"},"PeriodicalIF":3.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of facial nerve resection in parotid cancer abutting the facial nerve without preoperative paralysis: A multicentric propensity score-based analysis.","authors":"Florian Chatelet, Sylvie Chevret, Nicolas Fakhry, Caroline Even, Olivier Malard, Erwan de Monès, Nicolas Saroul, François Mouawad, Marie de Boutray, Olivier Mauvais, Sébastien Vergez, Diane Evrard, Christian Righini, Philippe Schultz, Robin Baudouin, Gilles Poissonnet, Sarah Atallah, Fabienne Haroun, Sylvain Morinière, Camille Evrard, Pierre Philouze, Agnès Paasche, Maria Lesnik, Yann Lelonge, Philippe Herman, Benjamin Verillaud","doi":"10.1016/j.ejso.2024.108746","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108746","url":null,"abstract":"<p><strong>Objectives: </strong>The management of the facial nerve (FN) is a major issue in parotid cancer, especially when there is no preoperative facial palsy and FN invasion is discovered intraoperatively. The aim of this study was to assess the impact of FN resection in patients with parotid cancer abutting the FN, without pretreatment facial palsy, using a propensity score matching.</p><p><strong>Materials and methods: </strong>Data from all patients treated between 2009 and 2020 for a primary parotid cancer abutting or invading the FN but without pretreatment facial palsy were extracted from the national multicentric REFCOR database. Three different definitions of tumors abutting the FN were used for sensitivity analyses, in a retrospective setting. Propensity score matching was used to assess the impact of FN resection on disease-free survival (DFS), overall survival (OS) and locoregional recurrence-free survival (LRRFS).</p><p><strong>Results: </strong>A total of 163 patients with parotid cancer abutting or invading the FN without pretreatment facial palsy were included. Among them, 99 patients (61 %) underwent FN resection. After overlap weighting and multiple imputation, no benefit of FN resection over preservation was found in terms of OS (HR = 1.21, p = 0.6), DFS (HR = 0.88, p = 0.5) and LRRFS (HR = 0.99, p = 1). Sensitivity analyses revealed similar results, and no significant efficacy was found in the subgroup analyses.</p><p><strong>Conclusion: </strong>In this retrospective study with propensity score analysis, FN resection did not improve survival outcomes in patients without preoperative facial palsy treated surgically for a primary parotid cancer abutting the FN. In line with recent guidelines, the results of this study suggest that FN preservation should be considered whenever possible in this specific group of patients.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"108746"},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescent probe applications and prospects in gastrointestinal cancer: A correspondence of bibliometric analysis.","authors":"Heng Bai, Si-Yang Liu, Yu Li, Jie Tian","doi":"10.1016/j.ejso.2024.108752","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108752","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"108752"},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendiceal adenocarcinoma-patterns of tumor spread and prognosis.","authors":"D Madonia, P Cashin, W Graf, L Ghanipour","doi":"10.1016/j.ejso.2024.108755","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108755","url":null,"abstract":"<p><strong>Introduction: </strong>Appendiceal adenocarcinoma represents a diagnostic and therapeutic challenge since it is prone to early lymphatic and peritoneal spread. We aimed to analyze the proportion of lymph node metastases in completion right hemicolectomy specimens, risk factors for peritoneal metastases (PM), and prognosis after definitive treatment.</p><p><strong>Methods: </strong>Ninety-three patients with appendiceal adenocarcinoma scheduled for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) in Uppsala 2004-2020 were identified from a prospectively maintained registry. Risk factors for PM were assessed based on the presence (CT + group, n = 55) or absence (CT - group, n = 37) of visible PM at baseline CT scan. Prognostic factors were analyzed based on the actual presence (PM group, n = 66) or absence (no PM group, n = 27) of PM.</p><p><strong>Results: </strong>The median age was 60 (26-78). Forty-eight patients were women. Resection of PM at initial surgery indicated an 80 % risk of finding PM at a follow-up exploration. R1 appendectomy and perforated appendix had a similar risk for PM (24 %,26 %) which increased to 38 % if both were present. Regional lymph node metastases occurred in 31 % in the CT + group vs. 14 % in the CT - group (p = 0.005) and was associated with poor survival HR 5.16 (1.49-17.81). The 5-year OS and DFS rates were 54 % and 29 % in the PM group.</p><p><strong>Conclusions: </strong>Patients with certain risk factors have a high likelihood of PM despite a normal CT scan, which justifies selective exploration at a HIPEC center. Regional lymph node spread supports the current practice of completion right hemicolectomy and is a significant prognostic factor.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"108755"},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}