Evidence map›Paper›PMID 40089619›Full record

ArticleAnnals of surgical oncology2025

Repeat Diagnostic Laparoscopy After Chemotherapy is Useful in Patient Selection for Conversion to Cytoreductive Surgery for Initially Unresectable Colorectal and Appendiceal Peritoneal Metastases: A Retrospective Cohort Study.

Yoshimasa Gohda, Hideaki Yano, Ryuichiro Suda, Alex Mirnezami, Nobuyuki Takemura, Yasushi Kojima, Naoyoshi Nagata, Takashi Kawai, Norihiro Kokudo

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Yoshimasa GohdaDepartment of Surgery, National Centre for Global Health and Medicine, Tokyo, Japan.
Hideaki YanoDepartment of Surgery, National Centre for Global Health and Medicine, Tokyo, Japan. yano-tky@umin.ac.jp.ORCID https://orcid.org/0000-0002-5202-1239
Ryuichiro SudaDepartment of General Surgery, Kimitsu Chuo Hospital, Chiba, Japan.
Alex MirnezamiSouthampton Complex Cancer and Exenteration Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Nobuyuki TakemuraDepartment of Surgery, National Centre for Global Health and Medicine, Tokyo, Japan.
Yasushi KojimaDepartment of Gastroenterology and Hepatology, National Centre for Global Health and Medicine, Tokyo, Japan.
Naoyoshi NagataDepartment of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.
Takashi KawaiDepartment of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.
Norihiro KokudoDepartment of Surgery, National Centre for Global Health and Medicine, Tokyo, Japan.

Funding

the National Centre for Global Health and Medicine grant grant number 21A1003
6 · The paper itself

Abstract

backgroundCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) enable effective management of colorectal and appendiceal peritoneal metastases (CAPM) despite high morbidity. This study aimed to evaluate the role of repeat diagnostic laparoscopy (rDL) after systemic ± intraperitoneal chemotherapy in the management of initially unresectable CAPM.

methodsThis retrospective cohort study included 70 consecutive patients with CAPM who underwent initial diagnostic laparoscopy (iDL). Patients with inoperable or equivocal CAPM underwent chemotherapy followed by rDL to assess the treatment response and possibility of conversion to CRS and HIPEC.

resultsCytoreductive surgery was deemed feasible for 29 patients and unlikely or equivocal for 41 patients based on iDL. Of the 29 resectable patients, 24 successfully underwent CRS and HIPEC after neoadjuvant chemotherapy. Among the 41 patients initially considered unresectable, 16 were deemed operable based on rDL after chemotherapy, and CRS and HIPEC were achieved for 14 patients (conversion). The median peritoneal cancer index was significantly reduced after chemotherapy for the 14 "conversion" patients, from 16 based on iDL to 11 based on rDL (p < 0.05). The conversion rate was 34% (14/41), with a 5-year survival rate of 14%. Treatment with CRS and HIPEC was achieved for 38 of 45 patients deemed operable based on either iDL or rDL (worst-case estimated positive predictive value, 84%).

conclusionDiagnostic laparoscopy is useful in predicting the likelihood of achieving CRS for patients with CAPM. Despite inoperability based on iDL, patients should be considered for rDL after chemotherapy to assess the possibility of conversion to CRS and HIPEC.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsAppendiceal NeoplasmsColorectal NeoplasmsCytoreduction Surgical ProceduresHyperthermic Intraperitoneal ChemotherapyLaparoscopyPatient SelectionPeritoneal NeoplasmsAdultAgedCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedConversionCytoreductive surgeryPeritoneal metastasesRepeat diagnostic laparoscopyUnresectable colorectal or appendiceal cancer

Identifiers

PMID40089619

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.