Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CS) as treatment of peritoneal carcinomatosis: preliminary results in Croatia.

Majerović, Mate and Milinović, Darko and Orešković, Slavko and Matošević, Petar and Mirić, Mirjana and Kekez, Tihomir and Kinda, Emil and Augustin, Goran and Silovski, Hrvoje (2011) Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CS) as treatment of peritoneal carcinomatosis: preliminary results in Croatia. Collegium Antropologicum, 35 (4). pp. 1349-52. ISSN 0350-6134

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Abstract

The purpose of our study was to evaluate initial results following introduction of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Cytoreductive Surgery (CS). Twenty two patients with intraperitoneal malignancy undergone cytoreductive surgery (CS) and hyperthermic intraoperative chemotherapy (HIPEC) between January of 2007 and January 2010. Nine patients had adenocarcinoma of colorectal origin, 8 patients had ovarian cancer, and 5 had pseudomyxoma peritonei. Inclusion criteria were diagnosis of peritoneal carcinomatosis based on intraoperative assessment during first operative procedure for intraabdominal malignancy or follow-up diagnostic imaging proof Excluded were patients with known malignant proliferation outside abdomen, liver metastasis and ASA score 4 and higher. All patients with pseudomyxoma peritonei diagnosis are alive, with mean follow-up time 24.8 months (range 15-35). In group of patients with adenocarcinoma from colorectal origin, 3 died, resulting in mean survival time 7.6 months (range 1-16). In group of patients with ovarian cancer, 2 died, resulting in mean survival time 13.8 months (range 0-31). Two patients died in early postoperative period. Most of the patients had some sort of mental disorder. Although HIPEC with CS improves survival, during introduction period higher morbidity and mortality could be expected.

Abstract in Croatian

HIPERTERMIČKA INTRAPERITONEALNA KEMOTERAPIJA (HIPEC) I CITOREDUKTIVNA KIRURGIJA (CS) KAO TERAPIJA ZA PERITONEALNI TUMOR: PRELIMINARNI REZULTATI IZ HRVATSKE ----- Svrha našeg istraživanja bila je iznijeti naše početne rezultate hipertermijske intraperitonealne kemoterapije (HIPEC) i citoreduktivne kirurgije (CS). Istraživanjem je obuhvaćeno 22 bolesnika s karcinozom peritoneuma ili primarnom zloćudnom tvorbom peritoneuma, u razdoblju od siječnja 2007. do siječnja 2010. Devet bolesnika imalo je adenokarcinom kolona kao primarni tumor, osam bolesnika karcinom jajnika, a pet pseudomiksom peritoneuma. Kriteriji za odabir bolesnika pogodnih za ovaj operativni zahvat bili su dijagnoza karcinomatoze peritoneuma za vrijeme prve operacije zbog maligne bolesti ili dijagnoza proširene intraperitonealne maligne bolesti na temelju radiološke obrade. Isključeni su bolesnici s prijeoperacijski poznatom proširenom malignom bolesti van abdomena, s metastazama jetre, i bolesnici čiji je anesteziološki rizik za operaciju bio ASA stadij 4 i više. Bolesnici s pseudomiksomom peritoneuma imali su srednje vrijeme praćenja 24,8 mjeseci (raspon 15–35), i do kraja praćenog razdoblja bili su svi živi. U skupini bolesnika s adenokarcinom kolona, troje je umrlo, što je rezultiralo srednjim vremenom preživljenja 7,6 mjeseci (raspon 1–16). U skupini bolesnika s karcinom jajnika, dvije bolesnice su umrle, što je rezultiralo srednjim vremenom preživljenja 13,8 mjeseci (raspon 0–31). Dvoje bolesnika umrlo je u ranom poslijeoperacijskom razdoblju. Većina bolesnika imala je poslijeoperacijski promjene psihološkog statusa određenog stupnja, najviše u vidu depresivnog sindroma. Iako HIPEC sa CS poboljšava preživljenje navedenih skupina bolesnika, tijekom razdoblja učenja ovog novog tipa operativnog zahvata može se očekivati veći morbiditet i mortalitet. Ranije upućivanje bolesnika u odabrane tercijarne ustanove vjerojatno bi pridonijelo smanjenju morbiditeta i mortaliteta.

Item Type: Article
MeSH: Adult ; Aged ; Antineoplastic Agents/administration & dosage ; Combined Modality Therapy ; Female ; Humans ; Hyperthermia, Induced/methods ; Male ; Middle Aged ; Peritoneal Neoplasms/mortality ; Peritoneal Neoplasms/therapy
Departments: Katedra za ginekologiju i opstetriciju
Katedra za kirurgiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Majerović, MateUNSPECIFIED
Milinović, DarkoUNSPECIFIED
Orešković, SlavkoUNSPECIFIED
Matošević, PetarUNSPECIFIED
Mirić, MirjanaUNSPECIFIED
Kekez, TihomirUNSPECIFIED
Kinda, EmilUNSPECIFIED
Augustin, GoranUNSPECIFIED
Silovski, HrvojeUNSPECIFIED
Date: December 2011
Date Deposited: 04 Apr 2012 10:51
Last Modified: 04 Apr 2012 10:51
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/1575

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