Starting a peritoneal carcinomatosis treatment program in a developing country: A prospective analysis

J Surg Oncol. 2021 Dec;124(7):1154-1160. doi: 10.1002/jso.26626. Epub 2021 Jul 29.

Abstract

Background: Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has become a valuable treatment strategy for selected patients with peritoneal carcinomatosis (PC). In Chile, it is an emerging technique. The aim of this study is to describe our protocol and report our perioperative results.

Methods: A prospectively maintained database for patients undergoing exploratory surgery for PC was reviewed. Eligible patients were selected using the peritoneal cancer index in correlation with the primary tumor. Patients underwent HIPEC using mitomycin C. Clinical data and postoperative results were analyzed.

Results: Seventy-six patients underwent exploratory surgery. Most patients were female (55%) with a median age of 62 years (range, 25-83). Complete CRS and HIPEC were achieved in 53 patients. The most frequent primary tumor site was colon-rectum (49%). The median number of resected organs was 4 (range, 1-13). Overall 90-day incidence of major complications was 26%. After a median follow-up of 26 months, 44 patients (83%) in the resected group were alive with no evidence of disease.

Conclusions: The PC treatment program at our institution has been established in a safe manner, with acceptable morbidity comparable to high-volume centers. A comprehensive preoperative evaluation, careful patient selection, and a cohesive team are necessary for successful results.

Keywords: Cytoreduction; HIPEC; hyperthermic intraperitoneal chemotherapy; peritoneal carcinomatosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibiotics, Antineoplastic / administration & dosage
  • Chemotherapy, Cancer, Regional Perfusion*
  • Chile
  • Cytoreduction Surgical Procedures*
  • Developing Countries
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced*
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / therapy*
  • Program Evaluation*
  • Prospective Studies

Substances

  • Antibiotics, Antineoplastic
  • Mitomycin