Correlation Between Intraoperative and Pathological Findings for Patients Undergoing Cytoreductive Surgery and...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a complex procedure for advanced cancers.
• Accurate assessment of surgical and pathological findings is crucial for patient outcomes.

Purpose of the Study:

• To investigate the correlation between intraoperative and pathological findings in colorectal cancer (CRC) patients undergoing CRS/HIPEC.
• To evaluate the prognostic value of these findings for patient survival.

Main Methods:

• Retrospective review of pathological reports from 108 CRC patients who underwent CRS/HIPEC (2009-2016).
• Separate calculation of intraoperative and pathological peritoneal cancer index (PCI), excluding negative pathological specimens (NPS).
• Use of Receiver Operating Characteristic (ROC) curves to compare prognostic accuracy.

Main Results:

• 18.6% of pathological specimens were NPS, with 69% of procedures showing NPS.
• Pathological PCI differed from intraoperative PCI in 46% of procedures.
• While intraoperative and pathological PCI showed similar prognostic value for overall survival (OS) and disease-free survival, positive specimen count in NPS patients was superior for predicting 2-year OS (ROC AUC 0.69 vs. 0.58, p=0.012).
• Patients with high ∆PCI (≥3) had a more favorable median OS than those with ∆PCI=0 (p=0.05).

Conclusions:

• Negative pathological specimens (NPS) are common in CRS/HIPEC for CRC.
• Pathological correlation, particularly the number of positive specimens in cases with NPS, holds prognostic significance and can refine survival predictions.
• A higher ∆PCI may indicate a better prognosis.