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Am J Surg. 2019 Sep 19. pii: S0002-9610(19)30848-7. doi: 10.1016/j.amjsurg.2019.09.017. [Epub ahead of print]

Trends in the indications for and short-term outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

Author information

1
The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
2
Mayo Clinic, Rochester, MN, USA.
3
MD Anderson Cancer Center, Houston, TX, USA.
4
Moffitt Cancer Center, Tampa, FL, USA.
5
University of California San Diego, San Diego, CA, USA.
6
Medical College of Wisconsin, Milkwaukee, WI, USA.
7
Emory University, Atlanta, GA, USA.
8
University of Cincinnati, Cincinnati, OH, USA.
9
University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
10
Johns Hopkins University, Baltimore, MD, USA.
11
City of Hope, Duarte, CA, USA.
12
University of Wisconsin, Madison, WI, USA.
13
The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA. Electronic address: Jordan.Cloyd@osumc.edu.

Abstract

BACKGROUND:

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an increasingly utilized strategy for patients with peritoneal surface malignancies (PSM).

METHODS:

The US HIPEC Collaborative was retrospectively reviewed to compare the indications and perioperative outcomes of patients who underwent CRS ± HIPEC between 2000 and 2012 (P1) versus 2013-2017 (P2).

RESULTS:

Among 2,364 patients, 39% were from P1 and 61% from P2. The most common primary site was appendiceal (64%) while the median PCI was 13 and most patients had CCR 0 (60%) or 1 (25%). Over time, median estimated blood loss, need for transfusion, and length of hospital stay decreased. While the incidence of any (55% vs. 57%; p = 0.426) and Clavien III/IV complications did not change over time, there was a decrease in 90-day mortality (5% vs. 3%; p = 0.045).

CONCLUSION:

CRS-HIPEC is increasingly performed for PSM at high-volume centers. Despite improvements in some perioperative outcomes and a reduction in postoperative mortality, morbidity rates remain high.

KEYWORDS:

Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy

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