Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal metastasis of non-primary origin

Complications and Mortality Rate of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy: Italian Peritoneal Surface Malignancies Oncoteam Results Analysis

“…The wide reported discrepancy in morbidity and mortality rates in the literature is mainly due to the different definitions and methods of classification used. In agreement with other authors, we believe that the NCI-CTCAE definition for types and grading of complications represents a legitimate metric of CRS-HIPEC quality, because it includes both medical and surgical conditions as well as many treatment-related complications and patients may die far beyond 30 days after surgery [ 1 , 3 , 4 , 5 , 16 , 26 , 27 , 28 ], as it occurred in approximately one third of our cases. Among the surgical complications, bleeding was the most frequent, followed by perforation and anastomotic leakage.…”

“…Our overall postoperative morbidity rate was in line with that reported from high-volume centers [ 1 , 2 , 3 , 4 , 5 , 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 26 , 27 , 28 , 29 , 30 ]. The wide reported discrepancy in morbidity and mortality rates in the literature is mainly due to the different definitions and methods of classification used.…”

“…Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has been increasingly considered an effective treatment for peritoneal surface malignancies (PSMs). Although it can significantly improve survival in selected patients with malignant mesothelioma and pseudomixoma peritoneii (PMP), the role in carcinomatosis originating from gastrointestinal and gynecological tumors is very promising but still under study [ 1 , 2 , 3 , 4 , 5 , 6 ]. The procedure has been widely criticized by the opponents due to the associated significant postoperative morbidity and mortality, thus preventing possibility of cure for many patients and clinical trials development.…”

“…A recent comparison with other high-risk surgical oncology procedures evaluating 34.114 patients showed that overall, 30-day mortality was lower in CRS/HIPEC (1.1%), compared with Whipple (2.5%), major hepatectomy (2.9–3.9%), esophagectomy (3.0%) [ 11 ]. The current morbidity and mortality rates vary from 22% to 45% and from 0.8% to 4%, respectively [ 1 , 2 , 3 , 4 , 5 , 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

The Onset of In-Vivo Dehydration in Gas -Based Intraperitoneal Hyperthermia and Its Cytotoxic Effects on Colon Cancer Cells

“…CRS and HIPEC is gaining more popularity in the field of surgery, as clinical trials describe advantageous results in highly selective patients ( 6 , 7 ). Despite this encouraging data, it is important to note that only patients suffering from limited diseases and without visible peritoneal seeding following CRS are considered to benefit from this therapeutic option ( 8 , 9 ). For patients with extensive PM who do not qualify for CRS and HIPEC, the option of pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been introduced to the clinical setting ( 10 , 11 ).…”