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Correlation Between Intraoperative and Pathological Findings for Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

  • Y. BergerEmail author
  • H. Jacoby
  • M. I. Kaufmann
  • A. Ben-Yaacov
  • G. Westreich
  • I. Sharon
  • L. Barda
  • N. Sharif
  • R. Nadler
  • N. Horesh
  • A. Nissan
  • M. Gutman
  • A. Hoffman
Gastrointestinal Oncology
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Abstract

Background

This study aimed to examine the correlation between intraoperative and pathological findings for patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) and to determine their prognostic significance.

Methods

Pathological reports of all colorectal cancer (CRC) patients undergoing CRS/HIPEC between 2009 and 2016 were retrospectively reviewed. Pathological specimens lacking tumor cells were defined as negative pathological specimens (NPS). The intraoperative peritoneal cancer index (PCI) and pathological PCI (excluding NPS) were calculated separately. Receiver operating characteristic (ROC) curves were applied to compare the prognostic value of intraoperative and pathological scoring systems.

Results

For 108 CRC patients, 113 CRS/HIPEC procedures were performed. Of 959 pathological specimens examined, 178 (18.6%) were NPS. Overall, 78 procedures (69%) showed NPS. In 52 procedures (46%), the pathological PCI differed from the intraoperative PCI (∆PCI > 0). The ROC areas for intraoperative PCI and pathological PCI were similar in predicting 1-year overall survival (OS), 2-year OS, and 1-year disease-free survival (all p values not significant). However, for the patients with NPS, the number of positive specimens (containing tumor tissue) was superior to intraoperative PCI in predicting 2-year OS (ROC under the curve areas, 0.69 vs. 0.58, respectively; p = 0.012). In addition, a subgroup of 15 patients with a high ∆PCI (≥ 3) had a more favorable median OS than a matched group of 30 patients with similar intraoperative PCI and a ∆PCI of 0 (median survival not reached vs. 21.6 months, respectively; p = 0.05).

Conclusions

In the majority of CRC CRS/HIPEC procedures, NPS may be found. Among patients with NPS, pathological correlation may have a prognostic significance.

Notes

Disclosure

There are no conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Y. Berger
    • 1
    Email author
  • H. Jacoby
    • 1
  • M. I. Kaufmann
    • 3
  • A. Ben-Yaacov
    • 2
  • G. Westreich
    • 2
  • I. Sharon
    • 2
  • L. Barda
    • 1
  • N. Sharif
    • 1
  • R. Nadler
    • 1
  • N. Horesh
    • 1
  • A. Nissan
    • 2
  • M. Gutman
    • 1
  • A. Hoffman
    • 1
  1. 1.Department of General Surgery and Transplantation-Surgery B, Chaim Sheba Medical Center, Tel HashomerAffiliated to Sackler School of MedicineTel AvivIsrael
  2. 2.Department of General and Oncological Surgery-Surgery C, Chaim Sheba Medical Center, Tel HashomerAffiliated to Sackler School of MedicineTel AvivIsrael
  3. 3.Department of Pathology, Chaim Sheba Medical Center, Tel HashomerAffiliated to Sackler School of MedicineTel AvivIsrael

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