TY  - BOOK
AU  - Sugarbaker, Paul H
TI  - Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases From a Small Bowel Adenocarcinoma: Multi-Institutional Experience
SN  - 1068-9265
PY  - 2018///
KW  - *Adenocarcinoma/th [Therapy]
KW  - *Antineoplastic Combined Chemotherapy Protocols/ad [Administration & Dosage]
KW  - *Cytoreduction Surgical Procedures
KW  - *Hyperthermia, Induced
KW  - *Intestinal Neoplasms/pa [Pathology]
KW  - *Peritoneal Neoplasms/th [Therapy]
KW  - Adenocarcinoma/sc [Secondary]
KW  - Adult
KW  - Aged
KW  - Cytoreduction Surgical Procedures/ae [Adverse Effects]
KW  - Disease-Free Survival
KW  - Female
KW  - Humans
KW  - Intestinal Neoplasms/th [Therapy]
KW  - Intestine, Small
KW  - Lymphatic Metastasis
KW  - Male
KW  - Middle Aged
KW  - Neoplasm Grading
KW  - Peritoneal Neoplasms/sc [Secondary]
KW  - Postoperative Complications/et [Etiology]
KW  - Registries
KW  - Severity of Illness Index
KW  - Survival Rate
KW  - Washington Cancer Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1994 - present
N2  - BACKGROUND: The multi-institutional registry in this study evaluated the outcome after cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal metastases (PM) from small bowel adenocarcinoma (SBA); CONCLUSION: The combined treatment strategy of CRS plus HIPEC achieved prolonged survival for selected patients who had PM from SBA with acceptable morbidity and mortality; METHODS: A multi-institutional data registry including 152 patients with PM from SBA was established. The primary end point was overall survival (OS) after CRS plus HIPEC; RESULTS: Between 1989 and 2016, 152 patients from 21 institutions received a treatment of CRS plus HIPEC. The median follow-up period was 20 months (range 1-100 months). Of the 152 patients, 70 (46.1%) were women with a median age of 54 years. The median peritoneal cancer index (PCI) was 10 (mean 12; range 1-33). Completeness of cytoreduction (CCR) 0 or 1 was achieved for 134 patients (88.2%). After CRS and HIPEC, the median OS was 32 months (range 1-100 months), with survival rates of 83.2% at 1 year, 46.4% at 3 years, and 30.8% at 5 years. The median disease-free survival after CCR 0/1 was 14 months (range 1-100 months). The treatment-related mortality rate was 2%, and 29 patients (19.1%) experienced grades 3 or 4 operative complications. The period between detection of PM and CRS plus HIPEC was 6 months or less (P = 0.008), and multivariate analysis identified absence of lymph node metastasis (P = 0.037), well-differentiated tumor (P = 0.028), and PCI of 15 or lower (P = 0.003) as independently associated with improved OS
UR  - https://dx.doi.org/10.1245/s10434-018-6369-x
ER  -