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Surgical and oncological outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a nonacademic center: 25‐year experience
Author(s) -
Nikiforchin Andrei,
Gushchin Vadim,
King Mary Caitlin,
Baron Ekaterina,
Nieroda Carol,
Sittig Michelle,
Sardi Armando
Publication year - 2021
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.26371
Subject(s) - medicine , hyperthermic intraperitoneal chemotherapy , interquartile range , surgery , quartile , single center , confidence interval , cytoreductive surgery , complication , cancer , general surgery , ovarian cancer
Background Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is predominantly performed and studied in academic centers. While developing CRS/HIPEC programs in nonacademic hospitals can increase accessibility, its safety and oncological efficacy remains unclear. We evaluated CRS/HIPEC outcomes in a nonacademic setting. Methods A single‐center descriptive study was conducted using a prospective database. Data of all CRS/HIPEC attempts in peritoneal surface malignancies (PSM) patients from October 1994 to November 2019 were extracted. Surgical and survival outcomes were measured. Center experience was assessed by quartiles of cases. Results Overall, 856 patients underwent 948 CRS/HIPEC attempts: 788 (83%) completed CRS/HIPECs, 144 (15%) aborted HIPECs, and 16 (2%) complete cytoreductions (CC‐0/1) without chemoperfusion. For completed CRS/HIPECs, median peritoneal cancer index was 24 (interquartile range: 10–33) and CC‐0/1 rate was 88%. Major complications occurred in 23.5% with 30‐ and 100‐day mortality of 1.0% and 2.3%, respectively. Median overall survival was 68 months (95% confidence interval [CI]: 50–86). Median progression‐free survival was 37 months (95%CI: 28–46). Incomplete cytoreduction and major complication rates decreased over time, while mortality remained low and constant. Conclusions CRS/HIPEC at a nonacademic center with advanced surgical and auxiliary services is a safe option to treat PSM with favorable surgical and oncological outcomes.