Morbidity and Mortality Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Data from the DGAV StuDoQ Registry with 2149 Consecutive Patients

Piso, Pompiliu; Nedelcut, Sebastian; Rau, Beate; Königsrainer, Alfred; Glockzin, Gabriel; Ströhlein, Michael A.; Hörbelt, Rüdiger; Pelz, Jörg

doi:10.1245/s10434-018-6992-6

Cited by 50 publications

(55 citation statements)

References 22 publications

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“…Due to the radical nature of these operations, major morbidity and mortality are not uncommon [14]. The literature varies on the extent, but recent studies have demonstrated major complication rate at about 20% with 30-day mortality at 2.3% [15]. Our study organized complications into an early and late stage.…”

Section: Discussionmentioning

confidence: 95%

Impact of insurance status on overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

Kim

Patel

Oliver

et al. 2020

Pleura and Peritoneum

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ObjectivesThe impact of insurance status on oncological outcome in patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is poorly understood.MethodsRetrospective study on 31 patients having undergone 36 CRS-HIPEC at a single institution (safety-net hospital) between 2012 and 2018. Patients were categorized as insured or underinsured. Demographics and perioperative events were compared. Primary outcome was overall survival (OS).ResultsA total of 20 patients were underinsured and 11 were insured. There were less gynecologic malignancies in the underinsured (p=0.02). On univariate analysis, factors linked to poor survival included gastrointestinal (p=0.01) and gynecologic malignancies (p=0.046), treatment with neoadjuvant chemotherapy (p=0.03), CC1 (p=0.02), abdominal wall resection (p=0.01) and Clavien–Dindo 3-4 (p=0.01). Treatment with neoadjuvant chemotherapy and abdominal wall resections, but not insurance status, were independently associated with OS (p=0.01, p=0.02 respectively). However, at the end of follow-up, six patients were alive in the insured group vs. zero in the underinsured group.ConclusionsIn this small, exploratory study, there was no statistical difference in OS between insured and underinsured patients after CRS-HIPEC. However, long-term survivors were observed only in the insured group.

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Section: Discussionmentioning

confidence: 95%

Impact of insurance status on overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

Kim

Patel

Oliver

et al. 2020

Pleura and Peritoneum

View full text Add to dashboard Cite

show abstract

“…Despite the adoption of CRS and HIPEC in many centers worldwide, this approach is still met with criticism. One of the arguments against CRS and HIPEC is high morbidity and mortality risk of these procedures (30)(31)(32). However, whether patients with PM from CRC can attain equivalent long-term survival with systemic therapy alone is doubtful (8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Thirty-Three Long-Term Survivors After Cytoreductive Surgery in Patients With Peritoneal Metastases From Colorectal Cancer: A Retrospective Descriptive Study

Kamada

Hida

Ishibashi

et al. 2020

Preprint

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BackgroundCytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in selected patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, little has been reported on characteristics and clinical course of long-term survivors with CRC-PM beyond 5 years. The objective of this study was to describe the clinical and oncological features affecting long-term survival of CRC-PM after comprehensive treatment.MethodsBetween January 1990 and April 2015, CRC-PM patients who underwent CRS with or without HIPEC in two Japanese tertiary hospitals and who survived longer than 5 years after the first CRS for PM were retrospectively investigated. Clinicopathological parameters and therapeutic details involved in long-term survival were reviewed. Patients were defined as cured if the recurrence-free interval was > 5 years after the last operation for metastases.ResultsThirty-three patients with a median peritoneal cancer index (PCI) of 4 (range, 1–27) were included. Complete cytoreduction was achieved in all 33 patients, and none had a rectal primary. Recurrence was observed in 19 patients (57.6%) at a median of 2.6 (range, 0.7–7.4) years. Sixteen patients (48.5%) were considered cured, of whom two never developed re-recurrence after the second surgery. The median PCI of cured group was 2 (range, 1–8).ConclusionsLong-term survival and cure were obtained after CRS in selected patients with CRC-PM. Low PCI, complete cytoreduction, and non-rectal primary are associated with long-term survival and cure in PM from CRC.

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“…Anastomotic leakage rates range from 0 to9% in experienced centers (6). The German DGAV StuDoQ Registry(Studien-, Dokumentations-und Qualitätszentrum der Deutschen Gesellschaft für Allgemein-und Viszeralchirurgie), the largest published national registry on CRS and HIPEC with 2149 patients, reports anastomotic leakage rates of 6% with rectal anastomosis being an independent prognostic factor (11). Anastomotic failure seems to be dependent on patient's gender or tumour histology but not on anastomotic technique (12).…”

Section: Case Presentationmentioning

confidence: 99%

Hyperthermic intraperitoneal chemotherapy and ileal pouch-anal anastomosis: A case report

Chardalias

Gklavas

Sotirova

et al. 2020

Preprint

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Background: CRS and HIPEC are established treatments for peritoneal carcinomatosis that prolong survival in carefully selected patients, considered to be a loco-regional disease. At the time of diagnosis 4-7% of patients have metastasis to the peritoneum. There is a lack of evidence in the literature if J-pouch can be applied simultaneously with HIPEC in order to improve quality of life of this patient group. Case presentation: We describe a rare case of a 41 year-old Caucasian male with Familial Adenomatous Polyposis which was diagnosed as metastatic colorectal cancer in the liver and peritoneum. He was treated with systemic chemotherapy followed by total proctocolectomy with a J-shaped IPAA, liver metastasectomy, right hemidiaphragm resection, CRS and HIPEC. This is the first reported case of J- Pouch formation along with HIPEC Conclusions: J-Pouch after CRS and HIPEC can be offered as a treatment as long as the patient is carefully being selected, in high experienced centers and the perioperative findings allow it.

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Morbidity and Mortality Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Data from the DGAV StuDoQ Registry with 2149 Consecutive Patients

Cited by 50 publications

References 22 publications

Impact of insurance status on overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

Impact of insurance status on overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

Thirty-Three Long-Term Survivors After Cytoreductive Surgery in Patients With Peritoneal Metastases From Colorectal Cancer: A Retrospective Descriptive Study

Hyperthermic intraperitoneal chemotherapy and ileal pouch-anal anastomosis: A case report

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