The Prognostic Role of Optimal Cytoreduction in Advanced, Bowel Infiltrating XXXX .

@entity43 @entity1 @entity902 @entity41
UNASSIGNED: ABSTRACT Aim: In locally @entity43 with bowel involvement appropriate surgical treatment is still controversial. Objective was to delineate factors to select those most likely to benefit from radical surgery in @entity1 with locally @entity43 . Methods: Therefore, we retrospectively evaluated 207 consecutive @entity1 with primary @entity43 who underwent primary surgery between 2000 and 2007. Every @entity1 received stage-related surgery and adjuvant @entity902 -based chemotherapy. Median follow-up was 53.5 months. Data collected included stage, histology, extent of cytoreduction and type of bowel resection. Univariate survival analyses were performed to investigate variables associated with outcome. Results: Optimal cytoreduction (OCR) (R  <= 1  cm) was achieved in 76.8%. Most @entity1 presented histologic grade 2/3 (96.6%), @entity43 (84.1%) and lymph node involvement (52.2%). Complete cytoreduction (R = 0  mm) has significant best prognostic impact in FIGO IIB-IV (p = .026). Regarding bowel involvement, bowel resection was performed in 82 @entity1 (39.6%). In this subgroup of @entity1 complete cytoreduction led to significant better overall survival than R > 0  mm-1  cm, even in FIGO IIIC-IV @entity1 (p = .027); this fact is independent of bowel resection. Noticeably, for survival bowel resection achieving @entity41 mass below 1  cm was also one main prognostic factor and even recurrence rate was associated with @entity41 mass. Conclusion: Our findings suggest that the major prognostic factor in @entity1 with @entity43 needing colorectal resection is completeness of cytoreduction. Therefore, in @entity43 @entity1 , multivisceral surgery is indicated to achieve OCR (R  <= 1  cm) with or without bowel resection with best prognostic impact.
