Ann Coloproctol.  2017 Feb;33(1):16-22. 10.3393/ac.2017.33.1.16.

Single Center Experience With Hyperthermic Intraperitoneal Chemotherapy

• Kim WR
• Hur H
• Min BS
• Baik SH
• Lee KY
• Kim NK

• KMID: 2377385
• DOI: http://doi.org/10.3393/ac.2017.33.1.16

Abstract

PURPOSE
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been proposed for controlling peritoneal seeding metastasis in some kinds of cancers, including those of colorectal origin, but their safety and oncological benefits are subjects of debate. We present our early experience with those procedures.
METHODS
Data were retrospectively collected from all patients with peritoneal carcinomatosis (PC) and pseudomyxoma peritonei (PMP) treated using CRS and HIPEC at Yonsei Cancer Center between July 2014 and July 2015. Short-term outcomes and risk factors for postoperative complications were analyzed.
RESULTS
Twenty-three patients with PC (n = 18) and PMP (n = 5) underwent CRS and HIPEC. Median follow-up and age were 2 months and 54 years, respectively. The median peritoneal carcinomatosis index score was 15, and CC0-1 was achieved in 78.3% of all patients. The median operation time and bleeding loss were 590 minutes and 570 mL, respectively. Grade-IIIa/grade-IIIb complications occurred in 4.3% (n = 1)/26.1% (n = 6) of the patients within 30 days postoperatively, and no 30-day mortalities were reported. Factors related to postoperative complications with CRS and HIPEC were number of organ resection (P = 0.013), longer operation time (P < 0.001), and amount of blood loss (P = 0.003). All patients treated with cetuximab for recurred colorectal cancer had grade-III postoperative complication.
CONCLUSION
Our initial experience with CRS and HIPEC presented about 30% grade-III postoperative complications. Therefore, expert surgeons need to perform those procedures with great caution in selected patients who might benefit from it.

Keyword

Cytoreduction Surgical Procedures; Peritoneal metastasis; Colorectal neoplasms; Pseudomyxoma peritonei

MeSH Terms

Carcinoma
Cetuximab
Colorectal Neoplasms
Cytoreduction Surgical Procedures
Drug Therapy*
Follow-Up Studies
Hemorrhage
Humans
Mortality
Neoplasm Metastasis
Postoperative Complications
Pseudomyxoma Peritonei
Retrospective Studies
Risk Factors
Surgeons
Cetuximab