Format

Send to

Choose Destination
J Visc Surg. 2019 Jul 16. pii: S1878-7886(19)30086-4. doi: 10.1016/j.jviscsurg.2019.06.007. [Epub ahead of print]

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy combined with liver resection for concurrent peritoneal and hepatic metastases of gastrointestinal and gynecological primary tumors.

Author information

1
Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany. Electronic address: philipp.horvath@med.uni-tuebingen.de.
2
Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany. Electronic address: stefan.beckert@med.uni-tuebingen.de.
3
Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany. Electronic address: alfred.koenigsrainer@med.uni-tuebingen.de.
4
Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany. Electronic address: silvio.nadalin@med.uni-tuebingen.de.
5
Department of General, Visceral and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807 Feldkirch, Austria. Electronic address: chirurgie@lkhf.at.

Abstract

AIM OF THE STUDY:

Cytoreductive surgery including liver resection and hyperthermic intraperitoneal chemotherapy provide survival benefit to selected patients but is associated with relevant morbidity and mortality rates. We aimed to report morbidity and mortality rates and parameters linked to increased morbidity.

PATIENTS AND METHODS:

Retrospective analysis of 37 patients who underwent liver resection and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy between 2006 and 2016. From a prospectively collected database the morbidity and mortality rates and survival data were analyzed.

RESULTS:

The mortality rate was 0% and grade III-IV morbidity was 42%. Re-operation rate was 27%. Patients with complications tended to have a higher peritoneal cancer index (16 vs. 13; P=0.23). The performance of rectal resections was statistically significantly associated with morbidity (P=0.02). Neither performance of other type of resections nor the hyperthermic intraperitoneal chemotherapy compound nor the completeness of cytoreduction score was associated with elevated morbidity. No complications related to liver resections were observed. Furthermore, origin of peritoneal metastases did not impact on occurrence of complications. Median overall survival for colorectal primaries was 22 months (range, 9-60 months) and 30 months (range, 12-58 months) for ovarian cancer.

CONCLUSION:

Simultaneous resection of hepatic and peritoneal metastases seems to provide a survival benefit for selected patients and is associated with acceptable morbidity and mortality rates. Knowledge of patients and operative factors linked to morbidity will help to provide a strict selection process and a safer surgical procedure.

KEYWORDS:

Colorectal cancer; Curative treatment; Liver metastases; Morbidity; Ovarian cancer; Peritoneal metastases

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center