scholarly journals Long-term outcomes with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal carcinomatosis: 10-year experience in a developing country

2018 ◽  
Vol 29 ◽  
pp. viii172
Author(s):  
F. Arias ◽  
E. Londoño-Schimmer ◽  
J. Otero ◽  
C.E. Cétares ◽  
G.E. Herrera ◽  
...  
2021 ◽  
Vol 15 ◽  
pp. 117955492110653
Author(s):  
Ozgul Duzgun ◽  
Murat Kalin

Background: The number of cases of cervical cancer with recurrence and peritoneal carcinomatosis is limited. In our study, we aimed to present the results of cytoreductive surgery hyperthermic intraperitoneal chemotherapy treatment and its 3-year early period results in patients with peritoneal metastases due to cervical cancer. Methods: Data of 306 patients who had undergone cytoreductive surgery hyperthermic intraperitoneal chemotherapy between May 2016 and 2021 because of intra-abdominal metastases were collected prospectively and evaluated retrospectively. Ten cases who had undergone cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy due to cervical peritoneal carcinomatosis were included in this study. Results: Average time of operation was 5 (range = 3-6) hours, mean average of peritoneal carcinomatosis index score was 12.3 (range = 7-36), and mean average of completeness of cytoreduction score was 1 in 2 patients and 0 in 8 patients. No mortality was recorded in 30 days postoperatively. Four patients relapsed and died because of pneumonia, coronavirus disease, pulmonary embolism, and terminal illness. These patients died at 2, 5, 6, and 12 months, respectively. Six patients are still alive and early period tumor relapse has not been reported during their follow-ups. Conclusions: This study has a limited number of patients and the results are early period results. The follow-up of patients were not long term. Therefore, it is hard to say that cytoreductive surgery hyperthermic intraperitoneal chemotherapy could be of any benefit looking at the results. Long-term results should be waited. Also, multicentered randomized cohort study with large sample size is required to evaluate this invasive procedure.


2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ao Xia ◽  
Xichao Zhai ◽  
Lubiao An ◽  
Bing Wang ◽  
Guanjun Shi ◽  
...  

Aim: As more and more centers has published their treatment results of pseudomyxoma peritonei (PMP) with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), the data from China is missing. Myxoma Department of Aerospace Hospital is the biggest center treating PMP in China. The purpose of this study is to report the early and long-term outcomes for PMP from this single center.Methods: 801 appendix-derived PMP out of 1008 consecutive patients treated in Myxoma Department of Aerospace Hospital between 2008 and 2019 were retrospectively analyzed.Results: Complete cytoreductive surgery (CCRS) was achieved in 240 (30%) patients with median PCI of 14(1~39), and the rest had maximal tumor debulking (MTD), HIPEC was implemented in 96.3% of CCRS and 78.6% of MTD. The major morbidity (grade III/IV) was 11.4% and the 30-day operative mortality is 0.7%. The 5- and 10-year OS of CCRS was 76.9% and 64.1%, which is significantly higher than MTD (5-, 10-year OS as 36.1%, 27.1%; p<0.001). On the univariate analysis, all prognostic factors (gender, PSS, interval time, prior chemotherapy, prior HIPEC, Peritoneal Cancer Index (PCI), completeness of cytoreduction (CC), HIPEC, pathology, present of serous ascites) were found to be associated with overall survival except for age. On multivariate analysis, only PCI>20, MTD, high pathologic grade and without HIPEC were independent factors predicting poorer prognosis.Conclusions: CCRS +HIPEC can benefit PMP well with controllable risks. MTD+HIPEC may benefit PMP as well when CCRS cannot be achieved after fully asscessment by an experienced peritoneal maglignacy center, but the surgery should be performed as limited as possible.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4098-4098
Author(s):  
Carlos A. Munoz-Zuluaga ◽  
Armando Sardi ◽  
Michelle Sittig ◽  
Victoria Eskay ◽  
Carol Ann Nieroda ◽  
...  

4098 Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) have become standard of care for patients with peritoneal carcinomatosis (PC) from appendiceal cancer (AC). We reviewed our experience and outcomes. Methods: A retrospective review of 614 CRS/HIPEC procedures from 1998-2016 was performed. Patient characteristics, surgical variables, and postoperative outcomes of first CRS/HIPEC were analyzed. Results: Two hundred ninety patients with PC from AC underwent 334 CRS/HIPEC’s. Median age at diagnosis and surgery was 52 (22-79) and 53 (23-81) years, respectively; 65% (187) were female. Prior surgical score was 0, 1, 2, and 3 in 20%, 38%, 37%, and 5%, respectively. Prior systemic chemotherapy was reported in 30% of patients. Median time from diagnosis to CRS/HIPEC was 4 months (0-182). Pre-operative tumor markers (CEA, CA-125, CA-19-9) were positive in 48% with one, two, and three positive markers in 21%, 15%, and 13% patients, respectively. Median Peritoneal Cancer Index was 29. Mitomycin-C was the HIPEC agent of choice. Mean operative time was 10 hours (R: 4-19) and median length of stay was 10 days (R: 4-93). Histology included 59% (171) peritoneal mucinous carcinomatosis (PMCA), 41% (119) disseminated peritoneal adenomucinosis (DPAM). Lymph nodes were positive in 47% PMCA. Complete cytoreduction rate was 87% (84% PMCA, 92% DPAM [p = 0.048]). Grade III-V complications occurred in 21%, with one 30-day mortality (0.3%). Overall, median progression-free survival (PFS) was 84 months with 5-year PFS of 56%. Median PFS was 43 months in PMCA and not reached in DPAM. Five year PFS was 40% PMCA and 82% DPAM (p < 0.001). Median overall survival (MOS) was 139 months with 61% 5-year OS. MOS was 53 months in PMCA and not reached in DPAM. Five year OS was 47% PMCA and 85% DPAM (p < 0.001). At 42-month median follow-up, 68% were alive (92 PMCA/103 DPAM) with 84% disease free (72 PMCA/92 DPAM), 28% died of disease (73 PMCA/7 DPAM). Conclusions: CRS/HIPEC is an effective treatment for patients with PC from AC providing meaningful long term survival in low and high grade tumors and should be considered the standard of care.


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