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High‐quality results of cytoreductive surgery and heated intraperitoneal chemotherapy perfusion for carcinomatosis at a low volume institution
Author(s) -
Bommareddi Swaroop R.,
Simianu Vlad V.,
Mann Lisa V.,
Mann Gary N.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23985
Subject(s) - medicine , perioperative , cytoreductive surgery , surgery , hyperthermic intraperitoneal chemotherapy , perfusion , intraperitoneal chemotherapy , peritoneal carcinomatosis , conventional pci , adverse effect , chemotherapy , retrospective cohort study , cancer , colorectal cancer , ovarian cancer , myocardial infarction
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. 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. 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). 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. J. Surg. Oncol. 2015 111:219–224 . © 2015 Wiley Periodicals, Inc.