Background and Objectives
Tumor deposit (TD) is a poor prognostic factor in colorectal cancer (CRC) patients. This study aimed to determine whether TD carry the same risk of peritoneal recurrence as known high‐risk (HR) features in CRC patients.
Methods
A retrospective cohort‐study of stage I−III CRC patients from 2010 to 2015 was conducted. TD group was defined by the presence of TD on histopathology whereas HR group was defined by the presence of obstruction, perforation, or T4‐stage.
Results
A total of 151 patients with CRC were identified, of which 50 had TD and 101 had a HR feature. The overall risk of peritoneal recurrence was higher in the TD group versus HR group (36.0% vs. 19.8%, p = 0.03). The risk of peritoneum as the site of first recurrence was also higher in the TD group (22.0% vs. 12.9%, p = 0.03). Overall cancer recurrence at any site was also higher in the TD group (56.0% vs. 34.7%, p = 0.01). Median time to first recurrence was 1.2 (0.7−1.9) years in the TD group compared to 1.4 (0.8−2.1) years in the HR group (p = 0.31).
Conclusions
In non‐metastatic CRC patients, TD might have a higher risk of tumor recurrence versus their HR counterparts. Alternative strategies for surveillance and treatment should be considered.
Background and objectives
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a complex treatment used in selected patients with peritoneal surface malignancies. HIPEC procedures are time and resource intensive. The primary aim of this analysis was to compare the experience of treating advanced abdominal tumors with CRS‐HIPEC before and during the coronavirus disease 2019 (COVID‐19) pandemic.
Methods
Patients included in this analysis received CRS‐HIPEC at a single center during either a prepandemic (March 18, 2019–March 17, 2020) or pandemic (March 18, 2020–February 5, 2021) interval. A retrospective chart review was performed.
Results
Our analysis included 67 patients: 30 (45%) treated prepandemic and 37 (55%) treated during the pandemic. Median age at the time of operation was 58 years (interquartile range: [49–65]); 53% of patients were women. Patients treated during the pandemic presented with higher peritoneal cancer index (PCI) scores with 32% (
n
= 12) having a PCI > 20 at the time of surgery (
p
= 0.01). Five patients had delays in surgery due to the pandemic. Rates of overall postoperative morbidity, reoperation, and readmission were not different between the cohorts.
Conclusions
Despite presenting with more extensive disease, patients treated with CRS‐HIPEC during the height of the COVID‐19 pandemic had comparable perioperative outcomes to patients treated prepandemic.
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