Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from digestive or primitive origin: A multi-institutional study of 1,290 patients
Bibliographic record
Abstract
4102 Background: Peritoneal carcinomatosis (PC) from non-gynecologic malignancies has long been regarded a terminal disease with a short median survival. Over the past decade, new locoregional therapeutic approaches combining cytoreductive surgery with perioperative intraperitoneal chemotherapy (PIC) have evolved and suggest improved survival. Methods: A retrospective multicentric study was performed in French speaking centers to evaluate the toxicity and the principal prognostic factors in order to identify the best indications. All patients had cytoreductive surgery and PIC (hyperthermic intraperitoneal chemotherapy (HIPEC) and or early postoperative intraperitoneal chemotherapy (EPIC)). Results: The study included 1290 patients from 25 institutions between February 1989 and December 2007. The principal etiologies of PC were colorectal adenocarcinoma (N=523), pseudomyxoma peritonei (N=301), gastric adenocarcinoma (N=159), peritoneal mesothelioma (N=88), and appendiceal adenocarcinoma (N=50). Mortality and morbidity rates were 4.1% and 33.8%, respectively. By multivariate analysis, age, extent of the PC, and the institution's experience had a significant influence on toxicity. The overall median survival was 34 months: 30 months for colorectal PC, not reached for pseudomyxoma peritonei, 9 months for gastric PC, 41 months for peritoneal mesothelioma, and 77 months for PC from appendiceal adenocarcinoma. Independent prognostic indicators by multivariate analysis were the institution's experience, etiology, completeness of cytoreductive surgery, extent of carcinomatosis, and lymph node involvement. Conclusions: The therapeutic approach combining cytoreductive surgery with PIC may achieve long-term survival in a selected group of patients with PC from non-gynecologic origin with acceptable mortality and morbidity. This treatment should be reserved to experienced institutions involved in the management of PC. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".