Peritoneal carcinomatosis is detected in 10-40% of patients with "first look" peritoneal tumors. Median survival after chemotherapy is generally 2-6 months. Use of cytoreductive surgery and intraoperative intraperitoneal chemohyperthermic perfusion (ISHTP) improves the end results significantly. The study included 45 cases of surgery: gastric cancer (15), ovarian and cervical carcinoma ('17), colorectal cancer (8) and miscellaneous cancers involving advanced peritoneal carcinomatosis (5). ISHTP procedure was carried out immediately after cytoreductive surgery including peritonectomy (Sugarbaker). Postoperative complication and lethality frequency was 37.7 and 22.2%, respectively; mean survival--17 months. Eight patients have survived without signs of relapse; three of them--for more than 2 years. Cytoreductive surgery plus ISHTP protocol for peritoneal carcinomatosis increases survival time 3-fold and improves quality of life.
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Ann Surg Oncol
January 2025
Department of Surgical Sciences, Colorectal Surgery, Uppsala University, Uppsala, Sweden.
Background: Prediction of open-close and long-term outcome is challenging in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Prognostic scores often include factors not known at baseline. Therefore, we aimed to analyze whether patterns of preoperative tumor markers could aid in prediction of open-close surgery and outcome in patients with pseudomyxoma peritonei (PMP) or colorectal peritoneal metastases (PM).
View Article and Find Full Text PDFAnn Surg Oncol
January 2025
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Background: Hematologic changes after splenectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) can complicate postoperative assessment of infection. This study aimed to develop a machine-learning model to predict postoperative infection after cytoreductive surgery (CRS) and HIPEC with splenectomy.
Methods: The study enrolled patients in the national TriNetX database and at the Johns Hopkins Hospital (JHH) who underwent splenectomy during CRS/HIPEC from 2010 to 2024.
J Am Coll Surg
January 2025
Section of Surgical Oncology, Department of General Surgery.
Introduction: Cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) can improve survival for patients with peritoneal surface malignancy. Completeness of cytoreduction correlates with prognosis. The role of gastrectomy in these patients is not well described.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Gynaecological Oncology, GRACE Centre, Somerset NHS Foundation Trust, Taunton, UK
SummaryWe report a case of small cell carcinoma of the ovary, hypercalcaemic type, a rare and aggressive form of ovarian cancer, causing an acute kidney injury. A woman in her mid-30s presented with a large pelvic mass and abdominal distention, this was associated with rapidly deteriorating renal function, which did not improve with standardised kidney injury treatment. There was a high suspicion of ovarian cancer.
View Article and Find Full Text PDFTech Coloproctol
January 2025
Peritonectomy and Liver Cancer Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia.
Background: The goal of cytoreductive surgery for peritoneal malignancy is to remove all macroscopic disease, which occasionally requires the excision of the umbilicus. While the absence of the umbilicus can be aesthetically undesirable for patients, umbilical reconstruction is rarely performed due to the perceived complexity and increased risk of wound infections (Sakata et al. in Colorectal Dis 23:1153-1157, 2021).
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