Unresectability during open surgical exploration in planned cytoreductive surgery and hyperthermic intraperitoneal chemotherapy*

Figures & data

Table 1. Reasons for unresectability.

	Unresectable (n = 23)
Reasons	%	(n)
Extensive mall bowel disease	65	(15/23)
Frozen pelvis	30	(7/23)
Unexpected liver metastasis	4	(1/23)

Table 2. Demographics of the unresectable and the successful group.

	Unresectable (n = 23)		Successful (n = 149)
Results	%	(n)	%	(n)	Odds ratio (CI)	p values
Age (median year)	47	(23–76)	52	(10–75)	0.99 (0.95–1.02)	.41
Female	61%	(14/23)	77%	(115/149)	0.46 (0.18–1.16)	.10
Tumour origin
Gastrointestinal	61%	(14/23)	49%	(73/149)	1
Colorectal	50%	(7/14)	67%	(49/73)
Appendiceal	43%	(6/14)	34%	(25/73)
Gastric	7%	(1/14)	0%	(0/73)
Gynaecological	26%	(6/23)	40%	(59/149)	0.53 (0.19–1.47)	.22
Ovarian	67%	(4/6)	98%	(58/59)
Uterine	17%	(1/6)	2%	(1/57)
Cervical	17%	(1/6)	0%	(0/57)
Peritoneum	13%	(3/23)	11%	(17/149)	0.92 (0.24–3.56)	.90

Table 3. Clinical presentation in the unresectable and the successful group.

	Unresectable (n = 23)		Successful (n = 149)
Results	%	(n)	%	(n)	Odds ratio (CI)	p values
Bloatedness	70%	(16/23)	23%	(31/136)	7.74 (2.92 to –20.51)	.00
Altered bowel habits	26%	(6/23)	10%	(14/135)	3.05 (1.03 to –9.01)	.04
Abdominal pain	44%	(10/23)	28%	(38/136)	1.98 (0.80 to –4.91)	.14
Loss of weight	26%	(6/23)	13%	(18/135)	2.29 (0.80 to –6.59)	.12
Nausea/Vomitingvomiting	17%	(4/23)	10%	(14/135)	1.82 (0.54 to –6.11)	.33
Abdominal distension	30%	(7/23)	8%	(11/135)	4.92 (1.67 to –14.54)	.00
Abdominal mass	26%	(6/23)	2%	(2/135)	23.47 (4.38 to –125.67)	.00
Pouch of Douglas nodules	9%	(2/23)	0%	(0/135)	31.51 (1.46 to –679.04)	.00

Table 4. Disease factor in the unresectable and the successful group.

	Unresectable (n = 23)		Successful (n = 149)
Results	%	(n)	%	(n)	Odds ratio (CI)	p values
High grade tumour	35%	(6/17)	11%	(15/138)	4.47 (1.45–13.85)	.01
Prior neoadjuvant chemotherapy	70%	(16/23)	70%	(104/149)	1.01 (0.39–2.63)	.98
Neoadjuvant cycles	11	(1 to 21)	6	(1–28)	1.11 (0.99–1.24)	.07
(Median months)
Multiple lines of chemotherapy	79%	(11/14)	30%	(30/99)	8.43 (2.19–32.42)	.00
Response to chemotherapy
Complete response	19%	(3/16)	66%	(63/95)	1
Partial response	19%	(3/16)	17%	(16/95)	3.94 (0.73–21.38)	.11
No response	12%	(2/16)	13%	(12/95)	2.50 (0.53–23.23)	.20
Progressive disease	50%	(8/16)	4%	(4/95)	42 (7.92–222.65)	.00
Previous surgery	61%	(14/23)	81%	(120/149)	0.38 (0.15–0.95)	.04
Suboptimal resection	45%	(9/14)	19%	(28/120)	3.54 (1.34–9.35)	.01
Disease-free interval (median months)	5	(3–26)	18	(0–1257)	0.86 (0.76–0.98)	.03

Table 5. Pre-operative investigation in the unresectable and the successful group.

	Unresectable (n = 23)		Successful (n = 149)
Results	%	(n)	%	(n)	Odds ratio (CI)	p values
Elevated tumour markers	90	(17/19)	50	(63/125)	8.37 (1.85–37.74)	.01
Thrombocytosis	36	(8/22)	11	(16/147)	4.68 (1.70–12.87)	.00
Anaemia	73	(16/22)	53	(78/147)	2.36 (0.87–6.37)	.09
Hypoalbumaemia	61	(11/18)	46	(67/147)	1.85 (0.68–5.05)	.23
CT ascites	100	(21/21)	31	(37/118)	93.45 (5.51–1584.33)	.00
CT omental thickening	95	(20/21)	18	(21/118)	92.38 (11.74 to 727.01)	.00
CT lymphadenopathy	48	(10/21)	23	(27/118)	3.06 (1.18–7.99)	.02
CT small bowel disease	29	(6/21)	4	(5/118)	9.04 (2.46–33.28)	.00