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J Surg Oncol. 2016 Feb;113(2):218-22. doi: 10.1002/jso.24115. Epub 2016 Jan 18.

Effect of a concomitant urologic procedure on outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

Author information

1
Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
2
Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
3
Division of Surgical Oncology, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Abstract

BACKGROUND AND OBJECTIVES:

To evaluate whether urologic procedures during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are associated with adverse postoperative outcomes.

METHODS:

We identified patients who underwent CRS-HIPEC at our institution from 2001 to 2012 and compared outcomes between operations that did and did not include a urologic procedure.

RESULTS:

A total of 938 CRS-HIPEC procedures were performed, 71 of which included a urologic intervention. Urologic interventions were associated with longer operative times (547 vs. 459 min, P < 0.001) and greater length of stay (15 vs. 12 days, P = 0.003). Major complications (Clavien III and IV) were more common in the urologic group (31% vs. 20%, P = 0.028). On multivariable analysis, urologic procedures were associated with a low anterior resection (OR: 2.25, 95%CI 1.07-4.74, P = 0.033) and a greater number of enteric anastomoses (OR: 1.83, 95%CI 1.31-2.56, P < 0.001). At a median follow up of 17 months (IQR 5.6-35 months), addition of a urologic procedure did not significantly impact overall survival for appendiceal or colorectal cancers.

CONCLUSION:

Urologic surgery at the time of CRS-HIPEC is associated with longer operative times, length of stay and increased risk of major complications, but not with decreased overall survival. J. Surg. Oncol. 2016;113:218-222. © 2016 Wiley Periodicals, Inc.

KEYWORDS:

cancer chemotherapy; peritoneal neoplasms; reconstructive surgical procedures; regional perfusion; urologic surgical procedures

PMID:
26775909
DOI:
10.1002/jso.24115
[Indexed for MEDLINE]

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