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Prognostic factors of early recurrence after complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2024年第27期12卷 6057-6069页

作者： Chao-Yu Chen Tzu-Hao Huang Li-Wen Lee Jrhau Lung Yu-Che Ou Chien-Hui Hung Huei-Chieh Chuang Min-Chi Chen Ting-Yao Wang Department of Obstetrics and Gynecology Chang Gung Memorial HospitalChiayi 613Taiwan Graduate Institute of Clinical Medical Sciences College of MedicineChang Gung UniversityTaoyuan 333Taiwan Department of Early Childhood Care and Education Shu-Zen Junior College of Medicine and ManagementKaohsiung 821Taiwan Division of General surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Department of Diagnostic Radiology Chang Gung Memorial HospitalChiayi 613Taiwan College of Medicine Chang Gung UniversityTaoyuan 333Taiwan Department of Medical Research and Development Chang Gung Memorial HospitalChiayi 613Taiwan Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Department of Anatomic Pathology Chang Gung Memorial HospitalChiayi 613Taiwan Department of Public Health Chang Gung UniversityTaoyuan 333Taiwan Division of Hematology and Oncology Department of Internal MedicineChang Gung Memorial HospitalChiayi 613Taiwan

BACKGROUND Although cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)offer the potential for long-term survival in peritoneal carcinomatosis,outcomes following CRS/HIPEC vary *** To identify the clinical factors associated with progression-free survival(PFS)after complete CRS/HIPEC in patients with colorectal/high-grade appendiceal,ovarian,and gastric *** We retrospectively evaluated the risk of recurrence within 1 year after CRS/HIPEC and its impact on overall survival(OS)in patients recruited between 2015 and *** regression models were used to assess the prognostic factors for the risk of recurrence within 1 ***–Meier survival curves and Cox proportional hazards models were used to evaluate the association between recurrence and *** Of the 80 enrolled patients,39 had an unfavorable PFS(12 was associated with a lower rate of achieving CC-0(P=0.027).The favorable PFS group had a significantly longer OS(median 81.7 mo vs 17.0 mo,P<0.001).CONCLUSION Achieving CC-0 was associated with a lower early recurrence rate and improved long-term *** study underscores the importance of selecting appropriate candidates for CRS/HIPEC to manage peritoneal carcinomatosis.

关键词： Peritoneal metastasis cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Predictor Recurrence

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Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2022年第32期10卷 11775-11788页

作者： Ya-Fen Wang Ting-Yao Wang Tzu-Ting Liao Meng-Hung Lin Tzu-Hao Huang Meng-Chiao Hsieh Vincent Chin-Hung Chen Li-Wen Lee Wen-Shih Huang Chao-Yu Chen Cancer Center Chang Gung Memorial HospitalChiayiTaiwan Division of Hematology and Oncology Department of Internal MedicineChang Gung Memorial HospitalChiayiTaiwan Division of Case Management Cancer CenterChang Gung Memorial HospitalChiayiTaiwan Health Information and Epidemiology Laboratory Chang Gung Memorial HospitalChiayiTaiwan Division of General surgery Department of SurgeryChang Gung Memorial HospitalChiayiTaiwan Division of Colorectal surgery Department of SurgeryChang Gung Memorial HospitalChiayiTaiwan Department of Psychiatry Chang Gung Memorial HospitalChiayi and Chang Gung UniversityTaoyuanTaiwan Department of Diagnostic Radiology Chang Gung Memorial HospitalChiayiTaiwanCollege of MedicineChang Gung UniversityTaoyuanTaiwan Department of Obstetrics and Gynecology Chang Gung Memorial HospitalChiayiTaiwan Department of Early Childhood Care and Education Shu-Zen Junior College of Medicine and ManagementKaohsiungTaiwanDepartment of Early Childhood Care and EducationShu-Zen Junior College of Medicine and ManagementKaohsiungTaiwan

BACKGROUND cytoreductive surgery and hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)for peritoneal surface malignancy can effectively control the disease,however it is also associated with adverse effects which may affect quality of life(QoL).AIM To investigate early perioperative QoL after CRS/HIPEC,which has not been discussed in *** This single institution,observational cohort study enrolled patients who received CRS/*** assessed QoL using the Taiwan residents version of the MD Anderson Symptom Inventory(MDASI-T)and European Organization Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ-C30).Participants completed the questionnaires before CRS/HIPEC(S1),at the first outpatient follow-up(S2),and 3 mo after CRS/HIPEC(S3).RESULTS Fifty-eight patients were *** was no significant perioperative difference in global health *** changes in physical and role functioning scores decreased at S2,and fatigue and pain scores increased at S2 but returned to baseline at *** regression analysis showed that age and performance status were significantly correlated with *** the MDASI-T questionnaire,distress/feeling upset and lack of appetite had the highest scores at S1,compared to fatigue and distress/feeling upset at S2,and fatigue and lack of appetite at *** leading interference items were working at S1 and S2 and activity at ***-T scores were significantly negatively correlated with the EORTC QLQ-C30 *** QoL and symptom severity improved or returned to baseline in most categories within 3 mo after CRS/*** findings can help with preoperative consultation and perioperative care.

关键词： cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Peritoneal carcinomatosis Quality of life Symptom distress Perioperative care

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cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treatment of gastric cancer with peritoneal carcinomatosis

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Chinese Journal of Cancer Research 2017年第1期29卷 86-92页

作者： Lynne M.Ellison Yangao Man Alexander Stojadinovic Hongwu Xin Itzhak Avital Bon Secours Cancer Institute Bon Secours Health System Richmond VA 23226 USA Laboratory of Oncology the First People's Hospital of Jingzhou City the First Hospital and Clinical Medical School of Yangtze University Jingzhou 434008 China Laboratory of Oncology Center forMolecular Medicine Medical School Yangtze University Jingzhou 434023 China

Although gastric cancer with peritoneal carcinomatosis is associated with poor prognosis and is generally treated with palliative systemic therapy, recent studies have shown that cytoreductive surgery（CRS） and hyperthermic intraperitoneal chemotherapy（HIPEC） may prove to be an efficacious treatment option. In addition to reviewing the natural history of gastric cancer with peritoneal carcinomatosis, this mini-review examines literature on the efficacy of CRS and HIPEC as compared to chemotherapy and surgical options. Both randomized and nonrandomized studies were summarized with the emphasis focused on overall survival. In summary, CRS and HIPEC are indeed a promising treatment option for gastric cancer with peritoneal carcinomatosis and large randomized clinical trials are warranted.

关键词： cytoreductive surgery hyperthermic intraperitoneal chemotherapy peritoneal carcinomatosis

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Machine learning-assisted ensemble analysis for the prediction of urinary tract infection in elderly patients with ovarian cancer after cytoreductive surgery

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World Journal of Clinical Oncology 2022年第12期13卷 967-979页

作者： Jiao Ai Yao Hu Fang-Fang Zhou Yi-Xiang Liao Tao Yang Department of Urology Jingzhou Central HospitalJingzhou Hospital Affiliated to Yangtze UniversityJingzhou 434020Hubei ProvinceChina Department of Obstetrics and Gynaecology Jingzhou Central HospitalJingzhou Hospital Affiliated to Yangtze UniversityJingzhou 434020Hubei ProvinceChina

BACKGROUND Urinary tract infection(UTI)is a common type of postoperative infection following cytoreductive surgery for ovarian cancer,which severely impacts the prognosis and quality of life of *** To develop a machine learning assistant model for the prevention and control of nosocomial *** A total of 674 elderly patients with ovarian cancer who were treated at the Department of Gynaecology at Jingzhou Central Hospital between January 31,2016 and January 31,2022 and met the inclusion criteria of the study were selected as the research subjects.A retrospective analysis of the postoperative UTI and related factors was performed by reviewing the medical *** machine learning-assisted models were developed using two-step estimation methods from the candidate predictive *** robustness and clinical applicability of each model were assessed using the receiver operating characteristic curve,decision curve analysis and clinical impact *** A total of 12 candidate variables were eventually included in the UTI prediction *** constructed using the random forest classifier,support vector machine,extreme gradient boosting,and artificial neural network and decision tree had areas under the receiver operating characteristic curve ranging from 0.776 to *** random forest classifier model,which incorporated factors such as age,body mass index,catheter,catheter intubation times,blood loss,diabetes and hypoproteinaemia,had the highest predictive *** These findings demonstrate that the machine learning-based prediction model developed using the random forest classifier can be used to identify elderly patients with ovarian cancer who may have postoperative *** can help with treatment decisions and enhance clinical outcomes.

关键词： cytoreductive surgery Machine learning Ovarian cancer Risk factors Urinary tract infection

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Risk factors for postoperative delayed gastric emptying in ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2021年第18期9卷 4644-4653页

作者： Guang-Xia Cui Zi-Jun Wang Jin Zhao Ping Gong Shuai-Hong Zhao Xiao-Xue Wang Wen-Pei Bai Yan Li Department of Gynecology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China Department of Peritoneal Caner surgery Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

BACKGROUND cytoreductive surgery and hyperthermic intraperitoneal chemotherapy(CRSHIPEC)has shown promising results in improving the survival of ovarian cancer *** the safety profiles of CRS-HIPEC exist,more attention should be paid to gastrointestinal complications,as the procedure involves a considerable proportion of bowel resection and *** To identify the risk factors for delayed gastric emptying in ovarian cancer treated with *** A cross-sectional study was *** to the inclusion and exclusion criteria,we retrospectively analyzed 77 patients admitted between March 2014 and April 2018 with advanced and recurrent ovarian cancer treated with CRSHIPEC in Beijing Shijitan Hospital of Capital Medical *** factors for delayed gastric emptying were analyzed using univariate *** of the statistically significant variables in the univariate analysis were entered into the multivariable logistic regression model to determine factors independently associated with delayed gastric *** Among the 77 included patients,36.4%(28/77)had delayed gastric emptying after *** median age and body mass index of all patients were 59 years and 22.83 kg/m^(2),*** chemotherapy was administered in 55 patients(71%).Sixty-two patients(81%)had a history of at least one previous pelvic *** median operation time and intraoperative hemorrhage volume were 630 min and 600 mL,*** was performed in 32 cases of primary ovarian cancer and 24 cases of *** median peritoneal cancer index was *** risk factors for delayed gastric emptying from the univariate analysis were body mass indexsurgery(X^(2)=4.498,P=0.034),history of chemotherapy(X^(2)=4.334,P=0.037),operation time≥7 h(X2=4.827,P=0.047),and intraoperative hemorrhage≥800 mL(X^(2)=7.112,P=0.008).Multivariable analysis revealed that age≥70 years(HR=7.1

关键词： Delayed gastric emptying cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Ovarian cancer Complication Nasogastric tube

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Effect of volume replacement with hydroxyethyl starch solution on splanchnic oxygenation in patients undergoing cytoreductive surgery for ovarian cancer

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Chinese Medical Journal 2003年第7期116卷 996-1000页

作者：郭向阳徐仲煌任洪智罗爱伦黄宇光叶铁虎 Department of Anesthesia Peking Union Medical College Hospital Department

Objective To investigate the effectiveness of using a medium molecular weight hydroxyethyl starch solution (HES) administered as a replacement for estimated blood loss (EBL) during cytoreductive surgery for ovarian cancer on splanchnic oxygenation Methods Forty two patients undergoing cytoreductive surgery for ovarian cancer were enrolled in this prospective randomized study As soon as the EBL exceeded 10% but was less than 20% of the estimated blood volume, the patients were randomly assigned to receive either a volume of lactated Ringer's solution (LRS) equal to three times the EBL (LRS group, n=22) or a volume of 6% HES equal to the EBL (HES group, n=20) Tissue oxygenation was assessed indirectly by measuring tonometric parameters, including the difference between gastric intramucosal PsCO 2 and arterial PaCO 2 (Ps a CO 2 gap), gastric intramucosal pH (pHi) and arterial lactate acid concentration at 30 min after induction of anesthesia (baseline value), 1 hour and 2 hours after skin incision, and at the end of surgery Results At the end of surgery,the Ps a CO 2 gap in the HES group (8 7±1 6 mmHg) was significantly lower than that of the LRS group (18 74±4 4 mmHg, P surgery with relatively large blood losses, volume resuscitation with medium molecular weight hydroxyethyl starch solution may improve splanchnic blood flow and tissue oxygenation

关键词： hydroxyethyl starch cytoreductive surgery gastric mucosa splanchnic oxygenation

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Giant hepatic extra-gastrointestinal stromal tumor treated with cytoreductive surgery and adjuvant systemic therapy:A case report and review of literature

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World Journal of Gastrointestinal surgery 2021年第3期13卷 315-322页

作者： Michel Ribeiro Fernandes Caroline Lorenzoni Almeida Ghezzi Tomaz J M Grezzana-Filho Flávia Heinz Feier Ian Leipnitz Aljamir Duarte Chedid Carlos Thadeu Schmidt Cerski Marcio Fernandes Chedid Cléber RositoPinto Kruel Department of Gastrointestinal surgery and Transplantation Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007RSBrazil Division of Radiology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-903RSBrazil Department of Pathology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007RSBrazil

BACKGROUND Primary extra-gastrointestinal stromal tumors(E-GIST)of the liver are *** clinical presentation may range from asymptomatic to bleeding or manifestations of mass *** surgery followed by adjuvant therapy with imatinib is the standard of ***,under specific circumstances,a cytoreductive approach may represent a therapeutic *** describe herein the case of an 84-year-old woman who presented with a tender,protruding epigastric *** computed tomography scan revealed a large,heterogeneous mass located across segments III,IV,V,and VIII of the *** initial approach was transarterial embolization of the tumor,which elicited no appreciable *** the large size and central location of the tumor and the advanced age of the patient,non-anatomic complete resection was *** to substantial intraoperative bleeding and hemodynamic instability,only a near-complete resection could be *** and immunohistochemical staining confirmed the diagnosis of primary E-GIST of the *** the risk/benefit ratio for therapeutic options,debulking surgery may represent a strategy to control pain and prolong *** SUMMARY Here,we present a case report of a patient diagnosed with E-GIST primary of the liver,which was indicated a cytoreductive surgery and adjuvant therapy with *** E-GIST primary of the liver is a rare conditional,the treatment is with systemic therapy and total resection ***,a cytoreductive surgery will be necessary when a complete resection is no possible.

关键词： Extra-gastrointestinal stromal tumor Primary gastrointestinal stromal tumor of the liver cytoreductive surgery Debulking surgery Case report

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The impact of urological resection and reconstruction on patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

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Asian Journal of Urology 2018年第3期5卷 194-198页

作者： Grace Hwei Ching Tan Nicholas B.Shannon Claramae Shulyn Chia Lui Shiong Lee Khee Chee Soo Melissa Ching Ching Teo Division of Surgical Oncology National Cancer Centre SingaporeSingapore Duke-NUS Medical School Singapore Department of Urology Singapore General HospitalSingapore

Objective:cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are increasingly being used to treat peritoneal *** resections and reconstruction(URR)are occasionally performed during the *** aim to evaluate the impact of these procedures on peri-operative outcomes of CRS and HIPEC ***:A retrospective review of a prospectively maintained database of all patients who underwent CRS-HIPEC from April 2001 to February 2016 was *** between patients who had surgery involving,and not involving URR were *** outcomes were the rate of major complications and the duration of stay in the intensive care unit(ICU)and *** outcomes were that of overall survival(OS)and prognostic factors that would indicate a need for ***:A total of 214 CRS-HIPEC were performed,21 of which involved a *** clinical characteristics did not vary between the groups(URR *** URR).Urological resections comprised of 52%bladder resections,24%ureteric resections,and 24%involving both bladder and ureteric *** bladder defects were closed primarily while ureteric reconstructions consisted of two end-to-end anastomoses,one ureto-uretostomy,five direct implantations into the bladder and three boari *** were more frequently required in patients with colorectal peritoneal disease(p Z 0.029),but was not associated with previous pelvic surgery(76%vs.54%,p Z 0.065).Patients with URR did not suffer more serious complications(14%vs.24%,p Z 0.42).ICU(2.2 days vs.1.4 days,p Z 0.51)and hospital stays(18 days vs.25 days,p Z 0.094)were not significantly *** a URR did not affect OS(p Z 0.99),but was associated with increased operation time(570 min vs.490 min,p Z 0.046).Conclusion:While concomitant URR were associated with an increase in operation time,there were no significant differences in postoperative complications or *** with colorectal peritoneal metastases a

关键词： cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Peritoneal carcinomatosis Urological procedures Urological reconstruction

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Impact of hyperthermic intraperitoneal chemotherapy on gastric cancer survival: Peritoneal metastasis and cytology perspectives

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World Journal of Clinical Oncology 2024年第7期15卷 840-847页

作者： Asada Methasate Thammawat Parakonthun Thita Intralawan Chawisa Nampoolsuksan Jirawat Swangsri Minimally Invasive surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Upper Gastrointestinal Cancer Center Siriraj Hospital Mahidol UniversityBangkok 10700Thailand

BACKGROUND Gastric cancer presenting with peritoneal metastasis is notably associated with diminished survival *** use of cytoreductive surgery in conjunction with hyperthermic intraperitoneal chemotherapy(HIPEC)has been shown to increase survival rates in these *** these advancements,debates persist regarding the magnitude of survival improvement attributed to this treatment *** present investigation examined survival outcomes following HIPEC in individuals diagnosed with gastric cancer and peritoneal metastasis,and it took a comparative analysis of patients exhibiting positive and negative cytological *** April 2013 and March 2020,84 patients with advanced gastric cancer treated at our institution were categorized into three cohorts:HIPEC(20 patients with peritoneal metastasis),cytology-positive(23 patients without peritoneal nodules but with positive wash cytology),and cytology-negative(41 patients with advanced gastric cancer,no peritoneal nodules,and negative wash cytology).The HIPEC cohort underwent gastrectomy with HIPEC,while the cytology-positive and cytology-negative groups received gastrectomy *** demographic,pat-hological,and survival data of the groups were *** The HIPEC cohort-predominantly younger females-exhibited relatively extended surgical durations and high blood ***,the complication rates were consistent across all three *** survival in the HIPEC group was 20.00±4.89 months,with 1-year,2-year,and 3-year overall survival rates of 73.90%,28.70%,and 9.60%,*** figures paralleled the survival rates of the cytology-positive group(52.20%at 1 year,28.50%at 2 years,and 19.00%at 3 years).Notably,47%of patients experienced peritoneal *** HIPEC may offer a modest improvement in short-term survival for patients with gastric cancer and peritoneal metastasis,mirroring the outcomes in cytology-positive ***,peritoneal recurrence r

关键词： cytoreductive surgery Gastric cancer Hyperthermic intraperitoneal chemotherapy Peritoneal metastasis Positive cytology

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Hyperthermic intraperitoneal chemotherapy and colorectal cancer:From physiology to surgery

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World Journal of Clinical Cases 2022年第30期10卷 10852-10861页

作者： Giorgio Ammerata Rosalinda Filippo Carmelo Laface Riccardo Memeo Leonardo Solaini Davide Cavaliere Giuseppe Navarra Girolamo Ranieri Giuseppe Currò Michele Ammendola Department Digestive Surgery UnitUniversity“Magna Graecia”Medical SchoolCatanzaro 88100Italy Interventional Oncology Unit with Integrated Section of Translational Medical Oncology National Cancer Research Centre“Giovanni Paolo Ⅱ”Bari 70124Italy Hepato-Biliary and Pancreatic Surgical Unit “F.Miulli”HospitalAcquaviva delle FontiBari 70124Italy Department of Medical and Surgical Sciences University of BolognaForlì40126Italy Department of General and Oncologic surgery Morgagni-Pierantoni HospitalForlì47121Italy Department of Human Pathology of Adult and Evolutive Age Surgical Oncology Division“G.Martino”HospitalUniversity of MessinaMessina 98122Italy

The pursuit of this paper is to collect principal reviews and systematic reviews about hyperthermic intraperitoneal chemotherapy(HIPEC) and cytoreductive surgery(CRS) used in colorectal cancer(CRC).We focus on principal biological aspects of CRC,hyperthermia effects,and surgical *** searched PubMed/MEDLINE for the principal reviews and systematic reviews published from 2010 to 2021 regarding the bimodal treatment(CRS + HIPEC) against local and advanced *** the literature,from several studies,it seems that the efficacy of bimodal treatment with an accurate CRS can extend overall *** these studies,there are not still any straight guidelines more detailed and scheduled about the use of combined treatment in patients with *** if the concept is still not very clear and shared,after a careful evaluation of the published data,and after some technical and pathophysiological descriptions,we concluded that it is possible to improve the overall survival and quality of life and to reduce the tumor relapse in patients affected by locally advanced(pT4) CRC with peritoneal metastases.

关键词： Hyperthermic intraperitoneal chemotherapy Colorectal cancer Peritoneum cytoreductive surgery

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