{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:28:11Z","timestamp":1740104891199,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CCSG P30CA012197"],"award-info":[{"award-number":["CCSG P30CA012197"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS\u2010HIPEC) is an effective surgical intervention for peritoneal surface malignancy. The effect of myometrium invasion on outcomes is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of our institutional registry with analysis of CRS\u2010HIPEC cases involving a hysterectomy. Compared cases with myometrium invasion versus those without invasion. Primary outcome was survival as measured by overall survival (OS) and disease\u2010free survival (DFS). Secondary outcome was the evaluation of risk factors for myometrium invasion based on multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 126 cases of CRS\u2010HIPEC involving a hysterectomy were identified. Ninety\u2010seven cases (76.9%) had no myometrium invasion and the remaining 29 cases (23.1%) had malignant invasion. The presence of myometrial invasion was a significant negative survival prognostic factor. The OS was halved with mean survival times of 2.8 (\u00b12.3) versus 5.8 (\u00b14.7) years for cases with and without invasion, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.002). Five\u2010year OS rates were also inferior with myometrium invasion at 17.4% versus 53.8% (odds ratio [OR]\u2009=\u20090.181, 95% confidence interval [CI]: 0.057\u20130.580, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). A similar trend was present with DFS with mean survival times of 1.4 (\u00b10.9) versus 3.7 (\u00b13.9) years for noninvasion and invasion cases (<jats:italic>p<\/jats:italic>\u2009=\u20090.009). The 5\u2010year DFS rates were 0% versus 34.8% (OR\u2009=\u20090.652, 95% CI: 0.549\u20130.775, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Secondary analysis significantly associated several risk factors with myometrium invasion to include lymph node positivity (OR\u2009=\u20092.539, 95% CI: 1.074\u20136.003, <jats:italic>p<\/jats:italic>\u2009=\u20090.012), colorectal primary tumors (OR\u2009=\u20092.248, 95% CI: 1.094\u20135.161, <jats:italic>p<\/jats:italic>\u2009=\u20090.035), and high\u2010grade tumors (OR\u2009=\u20092.160, 95% CI: 1.080\u20134.820, <jats:italic>p<\/jats:italic>\u2009=\u20090.038).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Myometrium invasion is a significant negative prognostic factor for survival following CRS\u2010HIPEC. Several risk factors are potentially predictive of identifying those at high\u2010risk for myometrium invasion.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27122","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T10:32:09Z","timestamp":1666780329000},"page":"450-456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of myometrium invasion on survival outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS\u2010HIPEC)"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0633-9454","authenticated-orcid":false,"given":"Christopher W.","family":"Mangieri","sequence":"first","affiliation":[{"name":"Section of Surgical Oncology, Wake Forest Baptist Health Medical Center Wake Forest University School of Medicine  Winston\u2010Salem North Carolina 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