Abstract
Background In peritoneal carcinomatosis (PC), increased life span and disease-free survival times are shown in patients with hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) following cytoreductive surgery (SRC). In this study, our main objective was to present our experience of performing SRC and perioperative intraperitoneal chemotherapy (HIPEC and EPIC) on patients with PC, in light of the literature. Methods Demographic data, follow-up results, peritoneal carcinomatosis index (PCI), completeness of cytoreduction (CCR) score, and morbidity and mortality rates of 180 patients treated with SRC + HIPEC + EPIC for PC at the Department of Surgical Oncology at Sivas Cumhuriyet University between January 2008 and July 2020 were analyzed retrospectively. Results Distribution of 180 PC cases according to primary organs included 53 ovarian, 39 colorectal, 33 stomach, 25 primary peritoneum, 10 uterus, 10 tuba, five soft tissue, and five appendix originated carcinoma. The average PCI of the cases detected preoperatively was 21 (5–30). Completeness of cytoreduction scores of CCR-0 in 102 cases, CCR-1 in 67 cases, CCR-2 in eight cases, and CCR-3 in three cases was obtained. Median operation time was 300 (200–540) minutes. Perioperative morbidity rate was 47.0%, and perioperative mortality rate was 13.5%. Conclusion The peritonectomy procedure is a difficult, long-lasting, troublesome intervention, but it is the most important treatment option with acceptable morbidity and mortality rates in patients selected for PC treatment in experienced centers.
Highlights
In peritoneal carcinomatosis (PC), increased life span and disease-free survival times are shown in patients with hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) following cytoreductive surgery (SRC)
Peritoneal carcinomatosis (PC) may present as primary tumors of the peritoneum or as metastases of gynecological and gastrointestinal tumors to the peritoneum. Life expectancy of those with PC is short; better survival results were obtained with the peritonectomy procedure [hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) following cytoreductive surgery (SRC)] as defined by Sugarbaker [1, 2]
Cases were evaluated in terms of age, gender, primary tumor origin, duration of surgery, peritoneal carcinomatosis index (PCI), completeness of cytoreduction (CCR) score, resection types, perioperative complications (Clavien Dindo classification), and mortality
Summary
Peritoneal carcinomatosis (PC) may present as primary tumors of the peritoneum or as metastases of gynecological and gastrointestinal tumors to the peritoneum Life expectancy of those with PC is short (average 3–6 months); better survival results were obtained with the peritonectomy procedure [hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) following cytoreductive surgery (SRC)] as defined by Sugarbaker [1, 2]. Even though the morbidity and mortality rates from the procedure are still high, it has become feasible in many centers due to an increase in experience among surgeons and increased technological developments [3]. Our aim in this study is to discuss and share the data we obtained when applying the peritonectomy procedure in PC treatment, in light of the literature
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