Peritoneal Disease Severity Score Predicts the Prognosis of Peritoneal Metastasis of Colorectal Origin: A 10-year Longitudinal Analysis of a Single-center Experience
Journal Title: Turkish Journal of Colorectal Disease - Year 2019, Vol 29, Issue 3
Abstract
Aim: Peritoneal Surface Disease Severity score (PSDSS) has been used in the evaluation of patients who are scheduled for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis of colorectal origin (PMCO). The aim of this study was to evaluate the validity of PSDSS in predicting prognosis in patients who underwent CRS + HIPEC for PMCO at our center. Method: Demographic data, operation data, histopathological features, perioperative morbidity and mortality, and oncologic follow-up data were obtained retrospectively from the database and analyzed. Peritoneal carcinomatosis index (PCI) values were calculated from preoperative computed tomographies. PSDSS was calculated by evaluating clinical symptoms, PCI and histology of primary tumor. Two PSDSS groups were formed: PSDSS 1 and 2 groups as low PSDSS group, and PSDSS 3 and 4 groups as high PSDSS group. Results: Sixty-one patients, including 36 females (59%) and 25 males (41%), with PMCO who underwent CRS and HIPEC were included in the study. Forty-four patients were enrolled to the low PSDSS group and 17 patients were enrolled to the high PSDSS group. Three patients (3.2%) died during the perioperative period. Twenty-one patients (34.4%) had perioperative complications. The mean follow-up was 35.0±23.2 months. During the follow-up period, 36 patients (59%) had recurrence and 44 patients (72.1%) died. The mean survival was 46.5±5.5 months, and 1-,3- and 5-year survival rates were 85%, 47% and 21%, respectively. There was no correlation between low and high PSDSS groups in terms of morbidity and recurrence (p=0.486 and p=0.385, respectively). Mortality was more frequent in high PSDSS group (94% vs 63%; p=0.024). The mean survival of patients in the low PSDSS group was significantly longer than in the high PSDSS group (57.2±6.7 months vs 16.5±2.6 months; p=0.001). Conclusion: The findings of this study demonstrated the validity of PSDSS in predicting prognosis in patients with PMCO who were scheduled for CRS and HIPEC.
Authors and Affiliations
Cihan Ağalar, Selman Sökmen, Naciye Çiğdem Arslan, Işıl Başaran Akın, Canan Altay, Aras Emre Canda, Funda Obuz, Sülen Sarıoğlu
Getting Better in Open Abdomen Surgery
No summary
A Rare Cause of Intestinal Obstruction: Mesodiverticular Band
Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Some of the major complications of MD are bleeding, intestinal obstruction and diverticulitis. So, we aim to indicate in thi...
Primary Colon Lymphoma Presenting with Obstructive and Hemorrhagic Symptoms
Colorectal lymphomas comprise less than 1% of colorectal malignancies and 1% of non-Hodgkin lymphomas. Colonic lymphomas are usually diagnosed after surgical resection performed due to complications. Herein we present th...
Utility of Methylene Blue Guided Limberg Flap on Longterm Recurrence in Adult Chronic Pilonidal Disease
Aim: Pilonidal sinus is a chronic intermittent disease, usually involving the sacrococcygeal area. This study was undertaken to compare the long-term results of peroperative methylene blue use in patients with pilonidal...
Birth Trauma: Sphincter Injuries
Aim: Fecal incontinence is a condition that has social and economic effects and that disrupts the quality of life. A complete definition of fecal incontinence is difficult. However, it can be defined as the failure to co...