Cytoreductive Surgery Followed by Hyperthermic Intraperitoneal Chemotherapy: Morbidity and Mortality Analysis of Our Patients

Abstract

Objective: The purpose of this study was to analyze the morbidity and mortality of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) with closed abdomen technique in the treatment of peritoneal surface malignancies. Material and Methods: Twenty-six patients (8 with ovarian cancer, 7 peritoneal mesothelioma, 6 colorectal cancer, 3 uterine sarcoma, 1 peritoneal carcinoma and 1 with gastric cancer) underwent 27 procedures. Peritonectomy was performed with complete removal of all the involved visceral and parietal peritoneum. HIPEC was performed with the closed abdominal technique using preheated (42.5 degrees C) perfusate for 60 minutes. EPIC was continued for postoperative 5 days. Results: All patients underwent resection of the lesions. Total pentonectomy was performed in 12 patients, while subtotal or partial peritonectomy was carried out in 14 according to the spread of carcinomatosis. Completeness of cytoreduction score of our patients was 0 in 18 patients, 1 in 6 patients and 2 in 2 patients. Major morbidity developed in 7 patients (27\%). CRS+HIPEC+EPIC yielded acceptable morbidity and mortality rates. Of the 26 patients, 20 (77\%) were alive without evidence of disease with a mean follow-up period of 13 6 months. Overall 1 year survival was 60\%. Conclusion: Cytoreductive approach combined with intraperitoneal chemotherapy prolongs survival in selected patients with peritoneal carcinomatosis (PC) with acceptable morbidity and mortality.