A CC-1 score denotes that the remaining tumor nodules are less than 0.25 cm. A CC-2 score indicates
tumor nodules between 0.25 and 2.5 cm. A CC-3 score indicates tumor nodules greater than 2.5 cm or a confluence of disease. The PIC protocol consisted of heated intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC). HIPEC was administered via the open abdominal technique to eradicate residual microscopic disease. The chemotherapeutic agent used was mitomycin-C (10-12.5 mg/m2) in 3 litres of 1.5% Inhibitors,research,lifescience,medical GNF-5? dextrose peritoneal dialysis solution at 42 °C for 90 minutes. Patients with suspected high-grade disease have been treated with bi-directional chemotherapy since 2010. These patients received oxaliplatin 350 mg/m2 IP and 5-fluorouracil 400 mg/m2 IV plus folinic acid 50 mg IV 1 hour prior to HIPEC. EPIC with 5-flurouracil (650 mg/m2) in 1 L of 1.5% dextrose peritoneal dialysis solution was administered. EPIC was delivered once stable postoperatively and was scheduled for a total of Inhibitors,research,lifescience,medical five days. This was withheld in patients who were at high risk of developing postoperative complications (e.g., multiple anastomoses) or had already developed early post-operative
complications. Statistical analysis Correlation Inhibitors,research,lifescience,medical between CA 19-9 levels and PCI was studied using the Pearson’s Correlation test. The relationship between CA 19-9 subgroups with histopathology and CC-score was examined with the Student’s t-test. Overall survival (OS) was defined as time from day of CRS to death. The impact of Inhibitors,research,lifescience,medical clinicopathologic and treatment variables on OS as guided by the literature was calculated using the Kaplan Meier method. Survival distributions were compared for significance using the log-rank test. Variables deemed significant by univariate analysis were entered into multivariate analysis using the Cox proportional hazards regression model for adjustment. Missing data was handled with the pairwise deletion approach; i.e. a variable may be unavailable for one patient but the
case was still included in the analysis of other variables. It was not anticipated that this would be statistically problematic, Inhibitors,research,lifescience,medical as missing tumor markers were largely from the same patients. A P-value of <0.05 was considered significant for all analyses. All statistical analyses were conducted by SPSS® for Windows version 20.0 (SPSS, Munich, Brefeldin_A Germany). Results Over a 16-year period, 224 patients were treated with CRS and PIC at our institution. Detailed histopathological reports and follow-up data were not available for 6 patients; they were excluded from this study. The median follow-up period was 19 months (range, 0-177, SD=29). The patient clinicopathologic data is summarized in Table 1. Table 1 Patient clinicopathologic data Survival outcomes for all histopathological subtypes Baseline CA 19-9, CEA and CA-125 were available for 178, 181 and 180 patients respectively. Median survival for the entire cohort was 102 months.
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