Cytoreduction with hyperthermic intraperitoneal chemotherapy: an appraisal of outcomes and cost at a newly established peritoneal malignancy program

Am J Surg. 2016 Sep;212(3):413-8. doi: 10.1016/j.amjsurg.2016.01.022. Epub 2016 Mar 21.

Abstract

Background: Outcome measures after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for peritoneal carcinomatosis in established centers are well defined. However, results from newly emerging US centers have not been reported.

Methods: This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC.

Results: Fifty-six patients underwent exploratory laparotomy with 36 receiving CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18, and the cytoreduction 0/1 rate was 92%. Postoperative major morbidity was 16.7% with one perioperative death. The median length of hospital stay and intensive care unit days were 9 and 3 days, respectively. Disease-free survival in high-grade vs low-grade tumors was 12.6 and 31.0 months (P, .03), respectively. Average direct cost for patients undergoing CRS/HIPEC was $25,917.

Conclusions: Our emerging center's short-term results are comparable with established programs with a trend toward more selective intraoperative judgment on who undergoes CRS/HIPEC.

Keywords: Cost; Cytoreduction; Cytoreductive surgery; HIPEC; Hyperthermic intraperitoneal chemotherapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Cytoreduction Surgical Procedures / methods*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / methods*
  • Laparotomy / methods*
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / therapy*
  • Reoperation
  • Retrospective Studies
  • Survival Rate / trends
  • United States / epidemiology
  • Young Adult