{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T12:19:02Z","timestamp":1781266742109,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with appendiceal mucinous neoplasm with peritoneal dissemination, a cytoreductive surgery (CRS) with perioperative chemotherapy may result in long\u2010term survival. Disease progression may require secondary cytoreductive surgery (SCRS) and other treatments in selected patients to improve survival and preserve an optimal quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical\u2010 and treatment\u2010related variables associated with the index CRS and SCRS were statistically assessed for impact on survival after SCRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 186 of 687 complete CRS patients (27.1%) had SCRS. Median follow\u2010up was 10 years and median survival was 12 years. In 95 males (51%) the median age was 45.0 years. Survival benefit with SCRS was observed if early postoperative intraperitoneal chemotherapy (EPIC) with 5\u2010fluorouracil (EPIC 5\u2010FU) or hyperthermic intraperitoneal chemotherapy (HIPEC) plus EPIC 5\u2010FU was used with the index CRS (hazard ratio [HR]: 0.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.0360; HR: 0.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.0004, respectively). By propensity matching of 51 pairs of patients, EPIC 5\u2010FU used with index CRS caused a survival advantage compared to HIPEC alone (<jats:italic>p<\/jats:italic>\u2009=\u20090.0100) with index CRS (<jats:italic>p<\/jats:italic>\u2009=\u20090.0100).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Use of EPIC 5\u2010FU at a complete index CRS was a prognostic variable that improved survival in patients requiring SCRS. Further investigations into the benefits of antiadhesion treatments with CRS and HIPEC are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27464","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T07:33:28Z","timestamp":1697096008000},"page":"349-357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Use of early postoperative intraperitoneal 5\u2010fluorouracil with index cytoreduction improves survival with secondary cytoreductive surgery"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2431-7366","authenticated-orcid":false,"given":"Paul H.","family":"Sugarbaker","sequence":"first","affiliation":[{"name":"Program in Peritoneal Surface Malignancy Washington Cancer Institute Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chang","sequence":"additional","affiliation":[{"name":"Westat Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199018020-00002"},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"Pharmacokinetic rationale for peritoneal drug administration in the treatment of ovarian cancer","volume":"62","author":"Dedrick RL","year":"1978","journal-title":"Cancer Treat Rep"},{"key":"e_1_2_8_4_1","first-page":"858","article-title":"Technical considerations in the use of intraperitoneal chemotherapy administered by Tenckhoff catheter","volume":"154","author":"Jenkins J","year":"1982","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_8_5_1","first-page":"5790","article-title":"Early postoperative intraperitoneal chemotherapy as an adjuvant therapy to surgery for peritoneal carcinomatosis from gastrointestinal cancer: pharmacological studies","volume":"50","author":"Sugarbaker PH","year":"1990","journal-title":"Cancer Res"},{"key":"e_1_2_8_6_1","first-page":"1916","article-title":"Portal levels and hepatic clearance of 5 fluorouracil after intraperitoneal administration in humans","volume":"41","author":"Speyer JL","year":"1981","journal-title":"Cancer Res"},{"key":"e_1_2_8_7_1","first-page":"47","volume-title":"Cytoreductive Surgery & Perioperative Chemotherapy for Peritoneal Surface Malignancy. Textbook and Video Atlas","author":"Van der Speeten K","year":"2017"},{"key":"e_1_2_8_8_1","first-page":"414","article-title":"Prospective randomized trial of intravenous versus intraperitoneal 5 fluorouracil in patients with advanced primary colon or rectal cancer","volume":"98","author":"Sugarbaker PH","year":"1985","journal-title":"Surgery"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1998.225"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.09.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199502000-00002"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2022.101757"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02602252"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1986.01400020125017"},{"issue":"1","key":"e_1_2_8_15_1","first-page":"49","article-title":"Current methodologies for clinical assessment of patients with peritoneal carcinomatosis","volume":"15","author":"Jacquet P","year":"1996","journal-title":"J Exp Clin Cancer Res"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200308000-00006"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199512000-00006"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-12864-8"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2022.07.018"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200108000-00009"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2006.03.079"},{"key":"e_1_2_8_22_1","first-page":"207","volume-title":"Cytoreductive Surgery & Perioperative Chemotherapy for Peritoneal Surface Malignancy. Textbook and Video Atlas","author":"Sugarbaker PH","year":"2017"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07219-9"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08234-x"},{"key":"e_1_2_8_25_1","first-page":"321","article-title":"Elective surgery in recurrent colon cancer with peritoneal seeding: when to and when not to proceed","volume":"1","author":"Esquivel J","year":"1998","journal-title":"Cancer Ther"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24703"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-10093-z"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900560"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-007-9462-0"},{"key":"e_1_2_8_30_1","first-page":"195","article-title":"Prevention of intraperitoneal adhesions by intraperitoneal lavage and intraperitoneal 5\u2010fluorouracil: experimental studies","volume":"87","author":"Pestieau SR","year":"2002","journal-title":"Int Surg"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neo.2020.09.006"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trecan.2019.12.008"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T08:06:07Z","timestamp":1705651567000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,12]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/jso.27464"],"URL":"https:\/\/doi.org\/10.1002\/jso.27464","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,12]]},"assertion":[{"value":"2023-09-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}