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EV230/#1006  Heterogeneity in organ resections performed during interval cytoreductive surgery and its impact on morbidity and progression-free suvival – a report from the Torpedo study
  1. Aditi Bhatt1,
  2. Mufaddal Kazi2,
  3. Snita Sinukumar3,
  4. Sanket Mehta4,
  5. Dileep Damodaran5 and
  6. Praveen Kammar4
  1. 1KD Hospital, Surgical Oncology, Ahmedabad, India
  2. 2Tata Memorial Road, Surgical Oncology, Mumbai, India
  3. 3Jehangir hospital, Surgical Oncology, Pune, India
  4. 4Saifee Hospital, Surgical Oncology, Mumbai, India
  5. 5MVR cancer centre, Surgical Oncology, Calicut, India

Abstract

Introduction In the TORPEDO (CTRI/2018/12/016789) study, a systematic total parietal peritonectomy (TPP) was performed in all patients undergoing interval cytoreductive surgery (iCRS). We report the heterogeneity in the organ resections at the four participating centers stratified according to disease extent, its impact on grade 3-4 morbidity and progression-free survival (PFS).

Methods Organ resections were performed in this study when required to achieve a complete gross resection. The 90-day morbidity was reported using ‘common toxicology criteria for adverse events’ (CTCAE) version 4.3. A comparison of outcomes was made in between different centers among patients with a surgical peritoneal cancer index (PCI) 0-15 and > 15.

Results Overall, 88/218(40.3%) patients had PCI>15. Patients with PCI>15 were significantly higher at centres 1-3 compared to centre 4 (32/62(51.6%), 38/69(55.0%), 13/26(50.0%) and 5/61(8.1%) respectively; p<0.001). Median duration of surgery(p=0.82), blood loss(p=0.51), ICU stay (p=0.27) and hospital stay(p=0.49) did not vary significantly among centers. Rectosigmoid resections and cholecystectomies were significantly higher at centers 1 and 2 while fewer splenectomies were performed at centre 4 (table 1). Overall, grade 3-4 morbidity was significantly higher at centre 1 but was similar in patients with PCI>15. The median PFS was 22 months with no significant difference between the four centres (figure 1). On multivariate analysis, PFS was better in patients not undergoing a splenectomy and in those not experiencing grade 3-4 morbidity.

Conclusion/Implications There were significant differences in organ resections performed at the 4 centers. Correlation with pathological findings is essential to elucidate benefit of a more radical versus conservative approach to organ resections.

Abstract EV230/#1006 Table 1

Variation in the organ resections and major morbidity performed at 4 centres with stratification according to surgical PCI

Abstract EV230/#1006 Figure 1

Progression-free survival curves for each centre

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