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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: long‐term results at S t G eorge H ospital, A ustralia
Author(s) -
Alzahrani Nayef,
Ferguson Jorgen S.,
Valle Sarah J.,
Liauw Winston,
Chua Terence,
Morris David L.
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13152
Subject(s) - medicine , term (time) , chemotherapy , surgery , quantum mechanics , physics
Background Peritoneal carcinomatosis ( PC ) results from the secondary spread of many intraabdominal tumour types, such as colorectal malignancy (colorectal cancer, CRC ), disseminated peritoneal adenomucinosis ( DPAM ), appendiceal cancer, ovarian carcinoma, sarcoma or from the occurrence of primary peritoneal disease such as peritoneal mesothelioma. The combination of cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) has seen improvements in survival in selected cases of these cancers. Methods Between 1996 and 2014, a prospective database of 675 patients was created for the peritonectomy unit at our hospital. In total, 827 peritonectomy procedures (including redo CRS ) were performed for the major subgroups of PC : DPAM 220; appendiceal cancer (peritoneal mucinous adenocarcinoma ( PMCA )) 191; CRC 234; diffuse malignant peritoneal mesothelioma ( DMPM ) 73 and others 109. There were 152 redo‐peritonectomy procedures within the total mentioned earlier ( CRC 26; DPAM 58; DMPM 18; appendix 40; other 10). Results The 5‐year survivals for DPAM and PMCA were 80% and 42% respectively. The 5‐year survivals for appendiceal cancer with peritoneal cancer index ( PCI ) <10, 10–20 and >20 were 60, 57 and 37% respectively ( P = 0.09). The 2‐ and 5‐year survivals for CRC were 56 and 24% respectively. The 5‐year survivals for PCI 0–5, 6–10, 11–15 and >15 were 59, 15, 7 and 0% respectively ( P = 0.000). The 5‐year survival for DMPM with PCI < 10, 10–20 and >20 were 100, 55 and 39% respectively ( P = 0.01). Conclusion CRS in combination with HIPEC provides a chance of long‐term survival in selected cases of PC when compared with systemic therapy alone.