Limited synchronous hepatic resection does not compromise peri-operative outcomes or survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
INTRODUCTION
There is uncertainty about whether hepatic resection (HR) combined with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is effective.


METHODS
Nine hundred and thirty-five consecutive CRS/HIPEC procedures were performed between 1996 and 2016 of which 132(14%) involved concomitant HR. Peri-operative complications were graded according to the Clavien-Dindo Classification. The association of concomitant HR with 19 peri-operative outcomes and overall survival (OS) was assessed using univariate and multivariate analyses.


RESULTS
Patients undergoing HR had a lower peritoneal disease burden (peritoneal cancer index <17) (46 vs 29%, P < 0.001) and underwent a shorter operation (<9 h) (53 vs 42%, P = 0.019). After accounting for confounding factors, HR was not associated with in-hospital mortality (Relative risk [RR], 2.47; 95% confidence interval [CI], 0.52-11.77; P = 0.577) or grade III/IV morbidity (RR, 1.18; 95%CI, 0.74-1.90; P = 0.488). Moreover, HR was not associated with an increased risk of other complications on univariate or multivariate analysis. Median OS for all colorectal cancer patients was 32.3 month with resected HM versus 30.5 months without HM (P = 0.587).


CONCLUSION
Given prudent patient selection, concomitant HR does not compromise peri-operative outcomes or survival after CRS/HIPEC.
['Saxena|Akshat|A|', 'Valle|Sarah J|SJ|', 'Liauw|Winston|W|', 'Morris|David L|DL|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001063:Appendiceal Neoplasms D016022:Case-Control Studies D010478:Chemotherapy, Cancer, Regional Perfusion D015179:Colorectal Neoplasms D065426:Cytoreduction Surgical Procedures D005260:Female D006498:Hepatectomy D017052:Hospital Mortality D006801:Humans D017114:Liver Failure, Acute D008113:Liver Neoplasms D008297:Male D008875:Middle Aged D061646:Operative Time D010051:Ovarian Neoplasms D010534:Peritoneal Neoplasms D055815:Young Adult
hepatic resection survival cytoreductive hyperthermic intraperitoneal mortality morbidity