Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have demonstrated their impact on disease-free survival (DFS) and overall survival (OS) of patients with peritoneal metastases (PM). However, prior literature lacks evidence regarding any follow-up beyond 5 years. In this study, we analyse long-term OS and DFS (more than 10 years of follow-up) of patients undergoing CRS + HIPEC in a specialized unit. We conducted a retrospective study that included only patients who underwent CRS + HIPEC from January 2001 to May 2012. Data collection was conducted by reviewing medical records and telephone calls to patients or relatives. A total of 86 patients were included. The mean PCI was nine (range 0-39) and complete cytoreduction (CC-0) was reached in 80% of patients. Postoperative complications Clavien-Dindo III-IV occurred in 27.9% of patients and the 30-day mortality rate was 2.3%. After 10 years of actual follow-up, OS was 33.7% and DFS was 31.4%. Considering the historical context in which the standard of care for patients with PM was palliation, the results obtained show that CRS + HIPEC was a valid option, with morbimortality comparable to other major abdominal surgeries and encouraging survival results, since, after 10 years of follow-up, almost one-third of patients are still alive and disease-free.
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http://dx.doi.org/10.3390/jcm13010297 | DOI Listing |
Cancers (Basel)
January 2025
Department of Surgery, University of California Irvine Medical Center, Orange, CA 92868, USA.
Despite the incremental improvement of survival with systemic therapy in metastatic gastric cancer (GC), the outcomes of patients with peritoneal carcinomatosis (PC) remain poor. The limited effectiveness of systemic therapy is attributed to the blood-peritoneal barrier and anarchic intra-tumoral circulation, which reduce the penetration of systemic therapy. Approaches that incorporate intraperitoneal (IP) chemotherapy, in addition to systemic therapies, may be a viable alternate strategy.
View Article and Find Full Text PDFFront Oncol
January 2025
Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Introduction: Low grade appendiceal mucinous neoplasms (LAMN) are indolent tumors that lack invasive potential but may present as pseudomyxoma peritonei. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) significantly improves both overall and recurrence free survival. While systemic chemotherapy is generally considered ineffective for LAMN, little literature is available to support this notion.
View Article and Find Full Text PDFJ Gastrointest Surg
January 2025
Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland.
Background: The preferred treatment option for patients with limited peritoneal metastasis (PM) is cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC).While the textbook outcome (TO) concept has been applied to other complex surgeries, its prevalence, determinants, and impact in patients with PM remain unclear. This study sought to identify factors influencing TO among individuals with PM undergoing CRS+HIPEC in an Eastern European population.
View Article and Find Full Text PDFAnn 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.
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