Assessing morbidity, mortality, and survival in patients with peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Publisher: Colégio Brasileiro de Cirurgiões Country of Publication: Brazil NLM ID: 7809515 Publication Model: eCollection Cited Medium: Internet ISSN: 1809-4546 (Electronic) Linking ISSN: 01006991 NLM ISO Abbreviation: Rev Col Bras Cir Subsets: MEDLINE

Original Publication: Rio de Janeiro : Colégio Brasileiro de Cirurgiões, [1974?]-

Peritoneal Neoplasms*/surgery ; Hyperthermia, Induced* ; Mesothelioma, Malignant*/drug therapy ; Colorectal Neoplasms*/therapy; Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Cytoreduction Surgical Procedures ; Survival Rate ; Combined Modality Therapy ; Prognosis

Objective: Peritoneal carcinomatosis (PC) indicates advanced stage cancer, which is generally associated with a poor outcome and a 6 to 12 months. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an option for treating patients with primary PC, such as mesothelioma, or secondary PC, such as colorectal cancer (CRC) or pseudomixoma. Until recently, such patients were deemed untreatable. The purpose of this study was to assess the results of CRS + HIPEC in patients with PC. Postoperative complications, mortality and survival rates were evaluated according to the diagnosis.
Results: Fifty-six patients with PC, undergoing full CRS + HIPEC between October 2004 and January 2020, were enrolled. The mortality rate was 3.8% and the morbidity rate was 61.5%. Complications were significantly higher in proportion to the duration of surgery (p<0.001). The overall survival rates, as shown in the Kaplan-Meyer curve, were respectively 81%, 74% and 53% at 12, 24 and 60 months. Survival rates according to each diagnosis for the same periods were 87%, 82% and 47% in patients with pseudomixoma, and 77%, 72% and 57% in patients with CRC (log-rank 0.371, p=0.543).
Conclusion: CRS with HIPEC is an option for pacients with primary or secondary PC. Although complication rates are high, a longer survival rate may be attained compared to those seen in previously published results; in some cases, patients may even be cured.

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Date Created: 20230419 Date Completed: 20230421 Latest Revision: 20230922

20240829

PMC10508679

10.1590/0100-6991e-20233421-en

37075463