Peritoneal carcinomatosis: intra-operative and post-operative assessment of patients undergoing cytoreduction and HIPEC.

ABSTRACT

BACKGROUND/AIMS: The aim of this study is to evaluate the results of intraoperative and postoperative parameters in patients presenting peritoneal carcinomatosis in which we performed cytoreductive surgery (CS) and hyperthermic introperitoneal chemotherapy (HIPEC). PATIENTS AND METHODS: The population included 55 patients with peritoneal carcinomatosis from colorectal origin in 19, gastric in 6, ovarian in 23, sarcomas in 5 and pseudomyxoma peritonei in 2. The peritoneal cancer index (PCI) which directly reflected the volume of the peritoneal disease in our study ranged from 3-29 (median 19,7). The main endpoints were morbidity, mortality, completeness of cytoreduction, survival rates and main intraoperative characteristics. RESULTS: The CS was considered as CCo (no residual disease) in 85% of patients. The mean survival in the patients with complete cytoreduction was 19 months versus 9,8 m in patients with incomplete cytoreduction (p < 0.05). The PCI was one of the most important factors concerning the long-term survival. Patients with PCI < 16 had better survival than these with PCI > 16 (11,8 vs 6,4 m p < 0.05). There are many intraoperative and postoperatives parameters with interesting results which predicts the postoperative outcome but not the long-term survival. The mortality rate was 3.6% (2 patients), twenty-two patients (41.5%) presented one or more complications. Actuarial 5 year survival was 52%. CONCLUSION: Interactive CS + HIPEC is on effective treatment strategy in PC patients.