{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T13:45:42Z","timestamp":1776951942580,"version":"3.51.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Cytoreductive surgery (CRS) is at the forefront of treatment for colorectal cancer with peritoneal metastasis or \u201ccarcinomatosis\u201d (CRC-PC). We report outcomes of the operative management of CRC-PC at a single center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>STUDY DESIGN:<\/jats:title>\n            <jats:p>We retrospectively reviewed our database from 1992 through 2021. The Kaplan-Meier method was used to estimate survival. Proportional hazards regression and multivariable models were used for assessments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>This study included 345 patients with mean age 53.5 years. Multivariate analysis revealed performance and resection status were associated with overall survival (OS; p &lt; 0.001). Within the R0\/R1 group, adverse impact on OS was found with increasing Peritoneal Cancer Index (PCI) score starting at 9 (hazard ratio [HR] = 1.98, CI 1.39\u20132.82, p = 0.0001) with the most significant hazard noted at PCI &gt;14 (HR = 2.35, CI 1.52\u20133.63, p = 0.0001). Incomplete resection (R2) had significantly worse OS compared with complete CRS 33.4 (n = 206) vs R2: 12.7 months (n = 139; p &lt; 0.0001. When stratified by PCI for the R0\/R1 group, median OS for PCI less than 10, 10 to 15, and greater than 15 was 38.2, 19.7, and 22.2 m, respectively (p = 0.0007 comparing PCI less than 10 and greater than 15). Ten-year increments\u20141991 through 2000, 2001 through 2010, 2011 through 2020\u2014revealed improvement in median OS (13.4 [n = 66], 19.3 [n = 139], and 29.1 months [n = 140]). However, by resection status, median OS remained stable for R0\/R1 (32.3 [n = 23], 31.1 [n = 76], and 34.1 months [n = 107]) and improved for R2 (5.2 [n = 43], 14.4 [n = 63], and 14.6 months [n = 33]). Clavien-Dindo complication rate (greater than or equal to grade III) was 29.4%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>CRS improves outcomes for CRC-PC compared with historic outcomes with nonoperative management. This benefit is greatest with complete resection and lower disease burden. Results of CRS (with or without heated intraperitoneal chemotherapy) are improving, and surgery for CRC-PC should be routinely considered.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/xcs.0000000000000091","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T01:09:53Z","timestamp":1649120993000},"page":"546-556","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Management of Colorectal Cancer with Peritoneal Dissemination: 30 Years of Experience at a Single Institution"],"prefix":"10.1097","volume":"234","author":[{"given":"Megan E","family":"Lundy","sequence":"first","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omeed","family":"Moaven","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen C","family":"Perry","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher W","family":"Mangieri","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian D","family":"Valenzuela","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory B","family":"Russell","sequence":"additional","affiliation":[{"name":"the Department of Biostatistics and Data Science (Russell), Wake Forest School of Medicine, Winston-Salem, NC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Bordelon","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perry","family":"Shen","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos I","family":"Votanopoulos","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward A","family":"Levine","sequence":"additional","affiliation":[{"name":"From the Department of General Surgery, Surgical Oncology (Lundy, Moaven, Perry, Mangieri, Valenzuela, Bordelon, Shen, Votanopoulos, Levine), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"R1-20250821","first-page":"21","article-title":"Molecular biology of peritoneal carcinomatosis.","volume":"134","author":"Jayne","year":"2007","journal-title":"Cancer Treat Res"},{"key":"R2-20250821","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1046\/j.1365-2168.2002.02274.x","article-title":"Peritoneal carcinomatosis from colorectal cancer.","volume":"89","author":"Jayne","year":"2002","journal-title":"Br J Surg"},{"key":"R4-20250821","doi-asserted-by":"crossref","first-page":"3756","DOI":"10.1002\/cncr.25116","article-title":"Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion versus systemic chemotherapy alone for colorectal peritoneal 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Results of the EVOCAPE 1 multicentric prospective study.","volume":"88","author":"Sadeghi","year":"2000","journal-title":"Cancer"},{"key":"R9-20250821","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1245\/s10434-008-9966-2","article-title":"8-year follow-up of randomized trial: cytorEduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer.","volume":"15","author":"Verwaal","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"R10-20250821","doi-asserted-by":"crossref","first-page":"3737","DOI":"10.1200\/JCO.2003.04.187","article-title":"Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer.","volume":"21","author":"Verwaal","year":"2003","journal-title":"J Clin 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PRODIGE 7.","volume":"45","author":"Quenet","year":"2019","journal-title":"European Journal of Surgical Oncology"},{"key":"R13-20250821","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1245\/s10434-013-3061-z","article-title":"Consensus guidelines from The American Society of Peritoneal Surface Malignancies on standardizing the delivery of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer patients in the United States.","volume":"21","author":"Turaga","year":"2014","journal-title":"Ann Surg Oncol"},{"issue":"11","key":"R14-20250821","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1002\/cncr.32874","article-title":"The Chicago consensus on peritoneal surface malignancies: Management of colorectal metastases.","volume":"126","author":"Izquierdo","year":"2020","journal-title":"Cancer"},{"key":"R15-20250821","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jamcollsurg.2013.12.013","article-title":"Intraperitoneal chemotherapy for peritoneal surface malignancy: Experience with 1,000 patients.","volume":"218","author":"Levine","year":"2014","journal-title":"J Am Coll Surg"},{"key":"R16-20250821","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1245\/ASO.2004.05.009","article-title":"Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy with mitomycin C for peritoneal carcinomatosis from nonappendiceal colorectal carcinoma.","volume":"11","author":"Shen","year":"2004","journal-title":"Ann Surg Oncol"},{"key":"R17-20250821","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.jamcollsurg.2006.12.048","article-title":"Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy: Experience with 501 procedures.","volume":"204","author":"Levine","year":"2007","journal-title":"J Am Coll Surg"},{"key":"R18-20250821","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1016\/j.ejso.2019.06.020","article-title":"Colic and rectal tumors with peritoneal metastases treated with cytoreductive surgery and HIPEC: One homogeneous condition or two different diseases? A systematic review and meta-analysis.","volume":"45","author":"Tonello","year":"2019","journal-title":"Eur J Surg Oncol"},{"key":"R19-20250821","doi-asserted-by":"crossref","first-page":"E748","DOI":"10.3390\/jcm9030748","article-title":"Impact of neoadjuvant chemotherapy on the outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases: A multi-institutional retrospective review.","volume":"9","author":"Beal","year":"2020","journal-title":"J Clin Med"},{"key":"R20-20250821","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1186\/s12885-019-5545-0","article-title":"Perioperative systemic therapy and cytoreductive surgery with HIPEC versus upfront cytoreductive surgery with HIPEC alone for isolated resectable colorectal peritoneal metastases: Protocol of a multicentre, open-label, parallel-group, phase II-III, randomised, superiority study (CAIRO6).","volume":"19","author":"Rovers","year":"2019","journal-title":"BMC Cancer"},{"key":"R21-20250821","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.jamcollsurg.2011.12.028","article-title":"Gene expression profiling of peritoneal metastases from appendiceal and colon cancer demonstrates unique biologic signatures and predicts patient outcomes.","volume":"214","author":"Levine","year":"2012","journal-title":"J Am Coll Surg"},{"key":"R22-20250821","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1200\/JCO.2003.11.126","article-title":"Superiority of oxaliplatin and fluorouracil-leucovorin compared with either therapy alone in patients with progressive colorectal cancer after irinotecan and fluorouracil-leucovorin: Interim results of a phase III trial.","volume":"21","author":"Rothenberg","year":"2003","journal-title":"J Clin Oncol"},{"key":"R23-20250821","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1056\/NEJMoa032691","article-title":"Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer.","volume":"350","author":"Hurwitz","year":"2004","journal-title":"N Engl J Med"},{"key":"R24-20250821","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jamcollsurg.2012.04.023","article-title":"Outcomes of repeat cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of peritoneal surface malignancy.","volume":"215","author":"Votanopoulos","year":"2012","journal-title":"J Am Coll Surg"},{"key":"R25-20250821","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jamcollsurg.2019.12.020","article-title":"Caregiver quality of life before and after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.","volume":"230","author":"Duckworth","year":"2020","journal-title":"J Am Coll Surg"},{"key":"R26-20250821","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1245\/ASO.2003.03.067","article-title":"Long-term survivorship and quality of life after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis.","volume":"10","author":"McQuellon","year":"2003","journal-title":"Ann Surg Oncol"},{"issue":"Suppl 5","key":"R27-20250821","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1245\/s10434-016-5547-y","article-title":"Quality-of-life evaluation after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.","volume":"23","author":"Dodson","year":"2016","journal-title":"Ann Surg Oncol"}],"container-title":["Journal of the American College of Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/XCS.0000000000000091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T20:08:05Z","timestamp":1755806885000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/XCS.0000000000000091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,3]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/xcs.0000000000000091","relation":{},"ISSN":["1072-7515"],"issn-type":[{"value":"1072-7515","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1,3]]}}}