共 44 条
Oncologic Risk Stratification Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Appendiceal Carcinomatosis
被引:6
作者:

Wagner, Patrick L.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Austin, Frances
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Zenati, Mazen
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Jaech, Aaron
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Mavanur, Arun
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Ramalingam, Lekshmi
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Jones, Heather L.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Holtzman, Matthew P.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Ahrendt, Steven A.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Zureikat, Amer H.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Pingpank, James F.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Zeh, Herbert J.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Bartlett, David L.
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h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA

Choudry, Haroon A.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA
机构:
[1] Univ Pittsburgh, Med Ctr, Div Surg Oncol, Pittsburgh, PA USA
关键词:
PERITONEAL SURFACE MALIGNANCIES;
QUALITY-OF-LIFE;
LONG-TERM SURVIVAL;
PSEUDOMYXOMA PERITONEI;
MORTALITY ANALYSIS;
HEALTH OUTCOMES;
CANCER-PATIENTS;
LEARNING-CURVE;
MORBIDITY;
DISSEMINATION;
D O I:
10.1245/s10434-015-5037-7
中图分类号:
R73 [肿瘤学];
学科分类号:
100214 ;
摘要:
Patients with peritoneal carcinomatosis (PC) of appendiceal origin demonstrate variable oncologic outcomes, despite aggressive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). We sought to devise a prognostic risk stratification system for oncologic outcomes following CRS-HIPEC. A total of 197 patients undergoing CRS-HIPEC for the treatment of appendiceal PC were reviewed from a prospective database. Kaplan-Meier survival curves and multivariate Cox regression models were used to identify prognostic factors affecting oncologic outcomes. Clinicopathologic variables affecting overall survival (OS) were utilized to develop a prognostic staging system and nomograms. Univariate and multivariate Cox regression analysis indicated that high-grade tumor histology, lymph node metastasis, and incomplete cytoreduction were high-risk features, adversely affecting OS. Patients were stratified on the presence of high-risk features as follows: low-risk patients had no risk factors (n = 102); intermediate-risk patients had one risk factor (n = 49); and high-risk patients had more than one risk factor (n = 46). Median OS for low-risk patients was not reached, and was 43 and 22 months for intermediate-risk and high-risk patients, respectively. Five-year OS was 72, 43, and 13 % for low-, intermediate- and high-risk patients, respectively (p < 0.0003 for low vs. intermediate risk, and p = 0.06 for intermediate vs. high risk). We propose a three-tier staging system for appendiceal PC following CRS-HIPEC, based on histologic grade, lymph node involvement, and completeness of cytoreduction. The presence of any one or more of these high-risk features significantly decreased survival in our single-institution database and provided the basis for a prognostic staging system and corresponding nomograms.
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页码:1587 / 1593
页数:7
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Inst Gustave Roussy, Dept Surg Oncol, F-94805 Villejuif, France Inst Gustave Roussy, Dept Surg Oncol, F-94805 Villejuif, France
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ANNALS OF SURGICAL ONCOLOGY,
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Esquivel, J
论文数: 0 引用数: 0
h-index: 0
机构:
St Agnes Hlth Care, Peritoneal Surface Malignancy Program, Baltimore, MD USA St Agnes Hlth Care, Peritoneal Surface Malignancy Program, Baltimore, MD USA
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Intraperitoneal chemohyperthermia using a closed abdominal procedure and cytoreductive surgery for the treatment of peritoneal carcinornatosis:: Morbidity and mortality analysis of 216 consecutive procedures
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ANNALS OF SURGICAL ONCOLOGY,
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Glehen, O
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Osinsky, D
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Cotte, E
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Kwiatkowski, F
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Freyer, G
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Isaac, S
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Trillet-Lenoir, V
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Sayag-Beaujard, AC
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

François, Y
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Vignal, J
论文数: 0 引用数: 0
h-index: 0
机构: Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France

Gilly, FN
论文数: 0 引用数: 0
h-index: 0
机构:
Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France Ctr Hosp Univ Lyon Sud, Dept Surg, F-69495 Pierre Benite, France