{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T23:25:20Z","timestamp":1771889120716,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"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":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>While systemic chemotherapy (SC) is the mainstay of treatment of peritoneal carcinomatosis from small bowel adenocarcinomas (SBA\u2010PC), its efficacy and outcomes remain poor. Therefore, the role of curative\u2010intent surgery needs to be better defined. Using a systematic review and meta\u2010analysis, this study aims to define the role of CRS\/HIPEC in patients with SBA\u2010PC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was performed using PubMed and MEDLINE following Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines for studies published between 1990 and 2023. Articles were scored and incorporated within approximate normality of means\/proportions formulae to compare outcomes of CRS\/HIPEC and SC alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies with 461 patients undergoing CRS\/HIPEC and seven studies with 285 patients undergoing SC alone were identified. In the CRS\/HIPEC group, 215 (46.6%) were male and the median age was 46.5\u201366 years. The primary tumor was located mostly in the duodenum (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009169, 36.7%) and ileum (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009108, 23.4%). Grade was unspecified in most patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009232, 50.3%). Median Peritoneal Cancer Index (PCI) ranged between 10 and 12, and 93.1% underwent complete cytoreduction (CC 0\/1). CRS\/HIPEC\u2010related major morbidity and mortality was 20.7% (SD\u2009=\u20092.5, 95% CI 15.6\u201325.6) and 1.7% (SD\u2009=\u20090.8, 95% CI 0.1\u20133.3), respectively. With a median follow\u2010up of 21.1 (SD\u2009=\u20091.1, 95% CI 18.9\u201323.3) months, CRS\/HIPEC demonstrated median overall survival of 32.3 (SD\u2009=\u20091.19, 95% CI 30\u201334.6) versus 14.5 (SD\u2009=\u20090.19, 95% CI 14.1\u201314.9) months for SC alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In comparison to SC alone, CRS\/HIPEC may result in long\u2010term survival with acceptable perioperative morbidity, in select SBA\u2010PC patients with low\u2010volume disease undergoing complete cytoreduction.<\/jats:p>\n                  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