title: Survival prognostic factors in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: analysis from a single oncological center.
abstract: BACKGROUND
  The aim of our study is to analyze survival, treatment-related morbidity, and safety in our experience of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
  
  
  METHODS
  Sixty-four patients were treated. Survival curves were calculated according to the Kaplan-Meier method. Univariate and multivariate analyses were done, and Cox's proportional hazard model was used to identify significant factors.
  
  
  RESULTS
  Global 5-year overall survival was 55%. Overall survival was also evaluated according to neutrophils to lymphocytes ratio and neutrophils to platelets ratio. Overall survival according to pre-operative serum albumin level shows a difference in the two groups (P < 0.05). We observed minor or no adverse events in 53 cases (89.8%), while 3 patients (5.1%) showed a grade III-IV complication and 3 post-operative deaths (5.1%). Post-operative complication also influenced overall survival; patients in whom a minor complication occurred had a 3-year overall survival (OS) of 62% vs. a 3-year OS of 28% in patients who underwent a major complication (P < 0.1).
  
  
  CONCLUSIONS
  Hyperthermic intraperitoneal chemotherapy (HIPEC) could be a valid and feasible option for selected patients affected by gastrointestinal malignancies' peritoneal carcinomatosis. Pre-operative parameters could be evaluated to choose patient who could benefit from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
authors.affiliation: Department of General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Via Dottori, 06132, Perugia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Graziosi
authors.affiliation: Department of General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Via Dottori, 06132, Perugia, Italy. elisabetta.marino1986@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Marino
authors.affiliation: Department of Clinical Oncology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: De Angelis
authors.affiliation: Department of Radiology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rebonato
authors.affiliation: Department of General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Via Dottori, 06132, Perugia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Donini
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000401:mortality*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
keywords: Gastrointestinal malignances; Intraperitoneal chemotherapy; Peritoneal carcinomatosis