Post-operative wall shear stress in the superior mesenteric artery: Biomarker of long term outcome in patients with residual disease after incomplete cytoreductive surgery for pseudomyxoma peritonei.
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
/ blood
Cytoreduction Surgical Procedures
Disease Progression
Female
Humans
Male
Mesenteric Artery, Superior
/ diagnostic imaging
Middle Aged
Neoplasm, Residual
/ physiopathology
Prospective Studies
Pseudomyxoma Peritonei
/ surgery
Ultrasonography, Doppler
Vascular Resistance
Blood flow velocity
Blood flow volume
Pseudomyxoma peritonei
Superior mesenteric artery
Wall shear stress
Journal
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
13
08
2018
revised:
19
02
2019
accepted:
01
03
2019
pubmed:
16
3
2019
medline:
9
6
2020
entrez:
16
3
2019
Statut:
ppublish
Résumé
After incomplete cytoreductive surgery (CRS), the assessment of pseudomyxoma peritonei (PMP) progression remains challenging. The objective was to assess the efficacy of wall shear stress (WSS) measured in superior mesenteric artery (SMA) to predict PMP progression in the postoperative setting to propose additional treatments. In a prospective study, 52 patients with PMP had Doppler-ultrasound examination of the SMA with WSS calculation within one year after CRS with a mean follow-up of 43.3 ± 18.3 months. Patients were categorized according to the completeness of CRS and clinical outcome: Group-1 (n = 19): complete CRS and no recurrence, group-2 (n = 20): incomplete CRS with slowly progressive disease (alive at 2 years without severe clinical symptoms), group-3 (n = 13): incomplete CRS and severe clinical symptoms or dead within two years. Results of WSS were compared between groups and to 24 healthy subjects. WSS measured in the SMA was superior in Group-3 (19.6 ± 8.2 dynes/cm Post-operative assessment of the WSS in the SMA in patients with incomplete CRS for PMP should be considered as biomarker of tumor progression in the postoperative setting. Therefore, WSS could be useful to target patients needing adjuvant systemic chemotherapy one year after CRS.
Sections du résumé
BACKGROUND
BACKGROUND
After incomplete cytoreductive surgery (CRS), the assessment of pseudomyxoma peritonei (PMP) progression remains challenging. The objective was to assess the efficacy of wall shear stress (WSS) measured in superior mesenteric artery (SMA) to predict PMP progression in the postoperative setting to propose additional treatments.
METHODS
METHODS
In a prospective study, 52 patients with PMP had Doppler-ultrasound examination of the SMA with WSS calculation within one year after CRS with a mean follow-up of 43.3 ± 18.3 months. Patients were categorized according to the completeness of CRS and clinical outcome: Group-1 (n = 19): complete CRS and no recurrence, group-2 (n = 20): incomplete CRS with slowly progressive disease (alive at 2 years without severe clinical symptoms), group-3 (n = 13): incomplete CRS and severe clinical symptoms or dead within two years. Results of WSS were compared between groups and to 24 healthy subjects.
RESULTS
RESULTS
WSS measured in the SMA was superior in Group-3 (19.6 ± 8.2 dynes/cm
CONCLUSION
CONCLUSIONS
Post-operative assessment of the WSS in the SMA in patients with incomplete CRS for PMP should be considered as biomarker of tumor progression in the postoperative setting. Therefore, WSS could be useful to target patients needing adjuvant systemic chemotherapy one year after CRS.
Identifiants
pubmed: 30871885
pii: S0748-7983(19)30308-7
doi: 10.1016/j.ejso.2019.03.001
pii:
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1727-1733Informations de copyright
Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.