{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:04:45Z","timestamp":1785539085677,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate apoptotic markers in tumor cells from hyperthermic intraperitoneal chemotherapy (HIPEC) effluent as a biomarker of treatment effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytoreductive surgery (CRS) combined with HIPEC is used to treat peritoneal surface malignancies (PSM), yet no validated method exists to assess HIPEC efficacy in real time. We explored whether apoptosis in residual tumor cells present in post\u2010HIPEC effluent correlates with oncologic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010four patients undergoing CRS\u2010HIPEC were prospectively enrolled. CD45\u207b cells were stained for Annexin\u2010PI by flow cytometry before and after HIPEC. The apoptotic response (\u0394apop) was defined as the increase in apoptosis post\u2010HIPEC. Clinical and procedural variables were correlated with peritoneal disease\u2010free survival (pDFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Tumor histologies included colorectal (50%), appendiceal (18.2%), ovarian (15.9%), and gastric (11.4%) primaries. Complete cytoreduction was achieved in 81.8% of patients. Median \u0394apop\u2009=\u20098.5% (IQR: 0%\u201337%). Responders had significantly prolonged pDFS (median not reached vs. 16 months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). On multivariable analysis, apoptotic response remained a significant predictor of pDFS (HR\u2009=\u20090.22; 95% CI: 0.05\u20130.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), independent of PCI and CCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this pilot study, apoptotic markers in HIPEC effluent are a histology\u2010agnostic assay that correlates with recurrence risk. This biomarker may improve patient selection for adjuvant therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70226","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:30:42Z","timestamp":1772998242000},"page":"705-711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Apoptotic Marker Analysis in Heated\u2010Intraperitoneal Chemotherapy Effluent Fluid Is Associated With Prognosis in Patients With Peritoneal Metastases"],"prefix":"10.1002","volume":"133","author":[{"given":"Eran","family":"Nizri","sequence":"first","affiliation":[{"name":"Department of Surgery B and Laboratory of Surgical Oncology Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Faculty of Medicine Tel Aviv University Tel Aviv 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