{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:06:02Z","timestamp":1751515562662,"version":"3.41.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Leukocytes have been reported to have tumor stimulating effects in colorectal cancer, among other malignancies. In line with this, earlier research has shown improved disease-free survival in patients with postoperative neutropenia compared to non-neutropenic patients following cytoreductive surgery (CRS) and hypertherm intraperitoneal chemotherapy (HIPEC).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Aim<\/jats:title>\n            <jats:p>To evaluate the impact of postoperative leukopenia after CRS and HIPEC on recurrence rate, survival, and risk of complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>All CRS and HIPEC-procedures for colorectal adenocarcinoma in the national Swedish HIPEC-registry since 2015 and local registries in Uppsala and Malm\u00f6 since 2003 until December 31st, 2021, were included (<jats:italic>n<\/jats:italic>\u2009=\u2009921). Patients who did not complete a full CRS and HIPEC procedure (<jats:italic>n<\/jats:italic>\u2009=\u200999), had incomplete macroscopic cytoreduction (<jats:italic>n<\/jats:italic>\u2009=\u200925) or a lack of information on leukocyte count (<jats:italic>n<\/jats:italic>\u2009=\u2009213) were excluded, resulting in 584 analyzed cases. Primary outcome was overall recurrence rate. Secondary outcomes were overall survival, recurrence-free survival, and perioperative complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Postoperative leukopenia was observed in 54 (9.2%) cases of which 32 (5.5%) developed severe leukopenia. No differences in patient characteristics were noted between those with or without leukopenia. There were no differences in 3-year recurrence rate, overall survival or 3-year recurrence-free survival, between the groups. Neoadjuvant chemotherapy treatment, HR 1.32 (95% CI: 1.02\u20131.71), higher PCI-score, HR 1.50 (95% CI: 1.09\u20132.05) and higher pN-stage HR 2.52 (95% CI: 1.74\u20133.65) were associated with higher 3-year recurrence rate. 3-year mortality was associated with neoadjuvant chemotherapy treatment, HR 1.82 (95% CI: 1.06\u20133.11), severe postoperative complication, HR 2.39 (95% CI: 1.39\u20134.13) and high PCI-score, HR 2.60 (95% CI: 1.31\u20135.14). Treatment with combined oxaliplatin\/irinotecan, HR 12.34 (95% CI: 4.51\u201333.74) was associated with developing postoperative leukopenia. Longer operation time, HR 2.30 (95% CI: 1.55\u20133.42), and severe leukopenia, HR 3.50 (95% CI: 1.25\u20139.77) were associated with postoperative complication.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Postoperative leukopenia did not impact recurrence rate or long-term survival in a statistically significant manner. Neoadjuvant chemotherapy and high PCI-score were associated with both recurrent disease and mortality within 3 years.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12957-025-03821-2","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T15:24:22Z","timestamp":1745940262000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative leukopenia after cytoreductive surgery and hypertherm intraperitoneal chemotherapy for colorectal carcinomatosis\u2013 causes and implication on outcomes in a population-based study"],"prefix":"10.1186","volume":"23","author":[{"given":"Mattias","family":"Lepsenyi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentinus","family":"Valdimarsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nader","family":"Algethami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Thorlacius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lana","family":"Ghanipour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Cashin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Asplund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elinor Bexe","family":"Lindskog","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella Jansson","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per J","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingvar","family":"Syk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"issue":"5","key":"3821_CR1","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1016\/j.ejso.2020.11.135","volume":"47","author":"RJ Lurvink","year":"2021","unstructured":"Lurvink RJ, Bakkers C, Rijken A, van Erning FN, Nienhuijs SW, Burger JW, Creemers GJ, Verhoef C, Lemmens VE, De Hingh IH. 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