Back to Search
Start Over
High-quality results of cytoreductive surgery and heated intraperitoneal chemotherapy perfusion for carcinomatosis at a low volume institution.
- Source :
-
Journal of surgical oncology [J Surg Oncol] 2015 Aug; Vol. 112 (2), pp. 219-24. Date of Electronic Publication: 2015 Aug 14. - Publication Year :
- 2015
-
Abstract
- Background and Objectives: Maximal cytoreductive surgery (CS) with heated intraperitoneal chemotherapy perfusion (HIPEC) for peritoneal carcinomatosis can improve oncologic outcomes, but is associated with significant morbidity. Whether low-volume experience with CS/HIPEC results in acceptable outcomes is unknown.<br />Methods: A retrospective review of all patients undergoing CS/HIPEC by a single surgeon. Experience was divided into first versus second 50 cases, and patient characteristics, operative details, and outcomes were compared.<br />Results: Ninety patients underwent 100 CS/HIPEC procedures (mean age 57 years, 68% female). -Compared to the initial experience, the second 50 cases included more high grade tumors (68 vs. 52%) and greater disease burden (PCI 14.2 vs. 12.4). Operative times remained unchanged and mean blood loss decreased (978 vs. 684 ml). Hospital stay (mean 18.1 vs. 12.6 days), major complications (24 vs. 16%), and perioperative mortality (8 vs. 2%) declined. Overall median survival was 18 months and was longer with low grade tumors (26 vs. 16 months, P = 0.03).<br />Conclusions: Patients experienced reduced EBL, fewer major complications, and shorter hospital stay, despite having higher disease burden and higher grade tumors. This suggests that even low-volume experience with CS/HIPEC can lead to a trend in reduction of adverse perioperative events with acceptable oncologic outcomes.<br /> (© 2015 Wiley Periodicals, Inc.)
- Subjects :
- Adult
Aged
Carcinoma drug therapy
Carcinoma surgery
Chemotherapy, Adjuvant
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Peritoneal Neoplasms drug therapy
Peritoneal Neoplasms surgery
Retrospective Studies
Treatment Outcome
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma therapy
Chemotherapy, Cancer, Regional Perfusion methods
Cytoreduction Surgical Procedures
Hospitals, Low-Volume
Hyperthermia, Induced
Peritoneal Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1096-9098
- Volume :
- 112
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 26274508
- Full Text :
- https://doi.org/10.1002/jso.23985