{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:33:42Z","timestamp":1790519622117,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications was also analyzed. Patients treated within a peritoneal carcinomatosis program in which a complete or optimal cytoreduction was achieved were retrospectively analyzed. They were divided into two groups based on whether preoperative immunonutrition (IMN) or not (non-IMN) were administered. Clinical and surgical variables and postoperative complications were gathered. Predictive values of major morbidity of CRP during the first 3 postoperative days (POD) were also evaluated. A total of 107 patients were included, 48 belonging to the IMN group and 59 to the non-IMN group. In multivariate analysis immunonutrition (OR 0.247; 95%CI 0.071\u20130.859; p = 0.028), and the number of visceral resections (OR 1.947; 95%CI 1.086\u20133.488; p = 0.025) emerged as independent factors associated with postoperative major morbidity. CRP values above 103 mg\/L yielded a negative predictive value of 84%. Preoperative intake of immunonutrition was associated with a decrease of postoperative major morbidity and might be recommended to patients with peritoneal carcinomatosis following CRS. Measuring CRP levels during the 3 first postoperative days is useful to rule out major morbidity.<\/jats:p>","DOI":"10.3390\/nu13072147","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T03:22:00Z","timestamp":1624418520000},"page":"2147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4213-8836","authenticated-orcid":false,"given":"Alba","family":"Fern\u00e1ndez-Candela","sequence":"first","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Calero","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-9074","authenticated-orcid":false,"given":"Lu\u00eds","family":"S\u00e1nchez-Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Escrig-Sos","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Jaume I (UJI), 12004 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Barreras","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9786-2659","authenticated-orcid":false,"given":"Francisco","family":"L\u00f3pez-Rodr\u00edguez-Arias","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6708-7185","authenticated-orcid":false,"given":"Laura","family":"Arma\u00f1anzas","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"},{"name":"Pathology and Surgery Department, Universidad Miguel Hernandez, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0165-0035","authenticated-orcid":false,"given":"Ana","family":"Murcia","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Elche University General Hospital, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-5175","authenticated-orcid":false,"given":"Antonio","family":"Arroyo","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"},{"name":"Pathology and Surgery Department, Universidad Miguel Hernandez, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Lacueva","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain"},{"name":"Pathology and Surgery Department, Universidad Miguel Hernandez, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ctrv.2016.06.007","article-title":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of gastrointestinal cancers with peritoneal metastases: Progress toward a new standard of care","volume":"48","author":"Sugarbaker","year":"2016","journal-title":"Cancer Treat. 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