Aim of the study To investigate the feasibility of enhanced recovery after surgery (ERAS) protocol for patients with primary peritoneal carcinomatosis (PC) undergoing cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (HIPEC) based on the length of hospital stay (LOS), return of bowel function, the incidence of postoperative complications, and quality of life (QLQ) analysis. Material and methods The study included a total of 37 patients with primary PC of different origin, who underwent cytoreductive surgery plus HIPEC. Patients were divided into 2 groups: Group I (nonERAS) – 20 patients and Group II (ERAS) – 17 patients. Results The median LOS in Group I (nonERAS) (12.35 ± 3.9) was longer than in Group II (ERAS) (6.8 ± 1.9) ( p < 0.01). The use of the ERAS protocol significantly contributed to the faster return of bowel function (peristalsis and stool) in the postoperative period ( p < 0.01). There was no statistically significant difference in the incidence of postoperative complications between the ERAS and nonERAS groups, which supports its clinical safety. Improved QLQ according to the obtained data has also been achieved due to the introduction of the principles of the ERAS protocol. Conclusions The obtained results prove the expediency and feasibility of the implementation of the ERAS protocol among patients undergoing cytoreductive surgery in combination with HIPEC.

Aim of the study was to establish the effect of the time interval between the initial optimal cytoreductive surgery and the initiation of adjuvant chemotherapeutic treatment (ACT) on the overall survival (OS) of patients with advanced ovarian adenocarcinoma. Materials and methods. Clinical cases of 60 patients with advanced ovarian adenocarcinoma (FIGO IIIC-IV), with the average age of 61 years, who underwent primary cytoreductive surgery (PDS) with the completeness of cytoreduction (CC)-0 score according to Shugarbaker and adjuvant chemotherapeutic treatment according to the standard first-line regimen were examined. Patients were categorized depending on the time between surgery and chemotherapeutic treatment into two groups: I-delay of chemotherapy for no more than one month (30 patients), II-from two to six months (30 patients). The OS data of the patients obtained from the national cancer registry were analyzed. Results. The results demonstrate an increase in OS of patients who underwent CC-0 PDS at the early initiation of ACT. Conclusions. Delaying the onset of ACT is an independent predictor of the worse OS after performing PDS. According to the data obtained, patients should start ACT within 1 month after the surgery. However, the findings are proved if CC-0 is achieved during the operation.

Colorectal cancer (CRC) is one of the most common malignancies. Susceptibility to malignant processes is mediated by genetically driven differences in the effectiveness of detoxification of potential carcinogens. One of the factors that may influence the risk of CRC is the glutathione-S-transferase (GST) gene family that encodes glutathione transferase enzymes. The GSTP1 gene is expressed both in normal and pathological conditions. Determining its specific alleles may be a marker of CRC. The aim of the research – to study GSTP1 gene polymorphism, which is likely to be more common among patients with primary metastatic colorectal cancer compared with healthy population. Materials and methods. The study involved 12 patients with primary metastatic colorectal cancer aged 43 to 72 years, the control group was represented by a sample of 31 people without cancer. Results. The incidence of advanced CRC in the presence of GSPT1 Val / Val (aa) polymorphism is statistically significantly higher than in the presence of Ile / Ile (AA) and Ile / Val (Aa) GSPT1 polymorphism. Conclusions. Among people with GSTP1 Val / Val (aa) polymorphism, primary CRC is 4.4 times more likely than among people with GSPT1 Ile / Ile (AA) and Ile / Val (Aa) polymorphisms, which are statistically significant (P < 0.05). The obtained results indicate the possibility of conducting a genetic study of GSTP1 polymorphism to form groups of potential risk of CRC.

We report a rare case of synchronous malignant peritoneal mesothelioma of the biphasic histological type and neuroendocrine tumor (NET) of the rectum without history of asbestos exposure. During 2 years since manifestation of the disease the patient underwent 3 cytoreductive surgeries (CRS): removal of the tumor of the sigmoid mesentery, resection of the rectosigmoid junction completeness of cytoreduction (CC) 0 (2017), omentectomy and partial parietal peritonectomy CC-0 (2017), atypical resection of S2, S4, S5 liver, the removal of the abdominal tumor with left-sided en-block hemicolectomy, partial parietal peritonectomy, argon-plasma coagulation of tumor foci on the mesentery of the small intestine CC-2 (2018) and Transanal Minimally Invasive Surgery-removal of neuroendocrine rectal tumor (2017). The patient underwent hyperthermic intraperitoneal chemotherapy (HIPEC) twice (during 2nd and 3rd CRS). Different regimens of HIPEC were performed: cisplatin + doxorubicin (2017) and metamycin C (2018). The patient received 4 courses of adjuvant chemotherapy with cisplatin plus pemetrexed in 2017 and 3 courses of the chemotherapy with gemcitabine and carboplatin plus bevacizumab in 2018. The patient survived 21 months after the detection of malignant peritoneal mesothelioma in 2017 and died 4 months after the last cytoreductive surgery from the progression of the disease. Histological subtype of MPMP remains important factor in the prognosis of the disease even on the early stages though patient had received the most aggressive variant of special treatment. Minimally invasive treatment tactics of NET demonstrated clinical effectiveness.