Evidence map›Paper›PMID 40301901›Full record

ArticleWorld journal of surgical oncology2025

Postoperative leukopenia after cytoreductive surgery and hypertherm intraperitoneal chemotherapy for colorectal carcinomatosis- causes and implication on outcomes in a population-based study.

Mattias Lepsenyi, Valentinus Valdimarsson, Nader Algethami, Henrik Thorlacius, Lana Ghanipour, Peter Cashin, Dan Asplund, Elinor Bexe Lindskog, Gabriella Jansson Palmer, Per J Nilsson and 1 more

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Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Mattias LepsenyiDepartment of Clinical Sciences Malmö, Section of Surgery, Lund University, Skåne University Hospital, Inga Marie Nilssons gata 47, Malmö, 20502, Sweden. mattias.lepsenyi@med.lu.se.
Valentinus ValdimarssonDepartment of Clinical Sciences Malmö, Section of Surgery, Lund University, Skåne University Hospital, Inga Marie Nilssons gata 47, Malmö, 20502, Sweden.
Nader AlgethamiDepartment of Clinical Sciences Malmö, Section of Surgery, Lund University, Skåne University Hospital, Inga Marie Nilssons gata 47, Malmö, 20502, Sweden.
Henrik ThorlaciusDepartment of Clinical Sciences Malmö, Section of Surgery, Lund University, Skåne University Hospital, Inga Marie Nilssons gata 47, Malmö, 20502, Sweden.
Lana GhanipourDepartment of Surgical Sciences, Section of Surgery, Uppsala University, Uppsala, Akademiska sjukhuset, Sweden.
Peter CashinDepartment of Surgical Sciences, Section of Surgery, Uppsala University, Uppsala, Akademiska sjukhuset, Sweden.
Dan AsplundDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Elinor Bexe LindskogDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Gabriella Jansson PalmerDepartment of Pelvic cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden.
Per J NilssonDepartment of Pelvic cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden.
Ingvar SykDepartment of Clinical Sciences Malmö, Section of Surgery, Lund University, Skåne University Hospital, Inga Marie Nilssons gata 47, Malmö, 20502, Sweden.

Funding

Avtal om läkarutbildning och forskning - ALF 2018-Project 0264
6 · The paper itself

Abstract

backgroundLeukocytes have been reported to have tumor stimulating effects in colorectal cancer, among other malignancies. In line with this, earlier research has shown improved disease-free survival in patients with postoperative neutropenia compared to non-neutropenic patients following cytoreductive surgery (CRS) and hypertherm intraperitoneal chemotherapy (HIPEC).

aimTo evaluate the impact of postoperative leukopenia after CRS and HIPEC on recurrence rate, survival, and risk of complications.

methodsAll CRS and HIPEC-procedures for colorectal adenocarcinoma in the national Swedish HIPEC-registry since 2015 and local registries in Uppsala and Malmö since 2003 until December 31st, 2021, were included (n = 921). Patients who did not complete a full CRS and HIPEC procedure (n = 99), had incomplete macroscopic cytoreduction (n = 25) or a lack of information on leukocyte count (n = 213) were excluded, resulting in 584 analyzed cases. Primary outcome was overall recurrence rate. Secondary outcomes were overall survival, recurrence-free survival, and perioperative complications.

resultsPostoperative leukopenia was observed in 54 (9.2%) cases of which 32 (5.5%) developed severe leukopenia. No differences in patient characteristics were noted between those with or without leukopenia. There were no differences in 3-year recurrence rate, overall survival or 3-year recurrence-free survival, between the groups. Neoadjuvant chemotherapy treatment, HR 1.32 (95% CI: 1.02-1.71), higher PCI-score, HR 1.50 (95% CI: 1.09-2.05) and higher pN-stage HR 2.52 (95% CI: 1.74-3.65) were associated with higher 3-year recurrence rate. 3-year mortality was associated with neoadjuvant chemotherapy treatment, HR 1.82 (95% CI: 1.06-3.11), severe postoperative complication, HR 2.39 (95% CI: 1.39-4.13) and high PCI-score, HR 2.60 (95% CI: 1.31-5.14). Treatment with combined oxaliplatin/irinotecan, HR 12.34 (95% CI: 4.51-33.74) was associated with developing postoperative leukopenia. Longer operation time, HR 2.30 (95% CI: 1.55-3.42), and severe leukopenia, HR 3.50 (95% CI: 1.25-9.77) were associated with postoperative complication.

conclusionsPostoperative leukopenia did not impact recurrence rate or long-term survival in a statistically significant manner. Neoadjuvant chemotherapy and high PCI-score were associated with both recurrent disease and mortality within 3 years.

Indexed as

AdenocarcinomaAntineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsCytoreduction Surgical ProceduresHyperthermic Intraperitoneal ChemotherapyLeukopeniaNeoplasm Recurrence, LocalPeritoneal NeoplasmsPostoperative ComplicationsAdultAgedCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleCytoreductive surgeryHyperthermic perioperative chemotherapyPostoperative complicationPostoperative leukopenia

Identifiers

PMID40301901
PMCPMC12042315

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