Article ; Online: Limitations of laparoscopy to assess the peritoneal cancer index and eligibility for cytoreductive surgery with HIPEC in peritoneal metastasis.
Langenbeck's archives of surgery
2022 Volume 407, Issue 4, Page(s) 1667–1675
Abstract: Purpose: We aimed to determine the value of laparoscopy to assess the intra-abdominal tumor extent and predict complete cytoreduction.: Methods: All patients at our department in the period from 2017 to 2021 that underwent laparoscopy to assess ... ...
Abstract | Purpose: We aimed to determine the value of laparoscopy to assess the intra-abdominal tumor extent and predict complete cytoreduction. Methods: All patients at our department in the period from 2017 to 2021 that underwent laparoscopy to assess peritoneal metastasis and subsequent open exploration with the intention to perform cytoreductive surgery (CRS) with HIPEC were retrospectively identified in a continuously maintained database. Results: Forty-three patients were analyzed. Peritoneal cancer index (PCI) determination by laparoscopy compared to open surgery was overestimated in five patients (11.6%), identical in eleven patients (25.6%), and underestimated in 27 patients (62.8%). PCI differences were independent of surgeons, tumor entities, and prior chemotherapy. Thirty-four patients (79.1%) were determined eligible for CRS with HIPEC during open exploration, whereas nine patients (20.9%) underwent a non-therapeutic laparotomy. Complete or almost complete cytoreduction was achieved in 33 patients (76.7%). In one patient, completeness of cytoreduction was not documented. Conclusions: We demonstrate a moderate agreement according to weighted Cohen's kappa analysis of PCI values calculated during laparoscopy and subsequent open exploration for CRS with HIPEC. Uncertainty of PCI assessment should therefore be kept in mind when performing laparoscopy in patients with peritoneal metastasis. |
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MeSH term(s) | Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Laparoscopy ; Peritoneal Neoplasms/secondary ; Retrospective Studies ; Survival Rate |
Language | English |
Publishing date | 2022-02-02 |
Publishing country | Germany |
Document type | Journal Article |
ZDB-ID | 1423681-3 |
ISSN | 1435-2451 ; 1435-2443 |
ISSN (online) | 1435-2451 |
ISSN | 1435-2443 |
DOI | 10.1007/s00423-022-02455-2 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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