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Related Experiment Video

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Re-do cytoreductive surgery for peritoneal surface malignancy: Is it worthwhile?

Vignesh Narasimhan1, Francis Cheung2, Peadar Waters2

  • 1Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|December 19, 2019
PubMed
Summary
This summary is machine-generated.

Iterative cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is safe for recurrent peritoneal surface malignancies. Achieving complete cytoreduction and managing peritoneal cancer index (PCI) are key to favorable outcomes.

Keywords:
Hyperthermic intraperitoneal chemotherapyIterative CRS and HIPECPeritoneal carcinomatosisRe-do cytoreductive surgery

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival for peritoneal surface malignancies (PSM).
  • Peritoneal recurrence is common after initial CRS and HIPEC.
  • Limited data exists on the efficacy of repeat CRS and HIPEC for recurrent PSM.

Purpose of the Study:

  • To evaluate the safety, efficacy, and outcomes of iterative CRS and HIPEC for recurrent PSM.
  • To compare outcomes between first-time and iterative CRS and HIPEC procedures.
  • To identify factors influencing survival after re-do CRS and HIPEC.

Main Methods:

  • Retrospective review of patients undergoing re-do CRS and HIPEC for recurrent PSM.
  • Comparison of morbidity and survival between first and iterative CRS and HIPEC cases.
  • Analysis of factors affecting overall survival, including completeness of cytoreduction and Peritoneal Cancer Index (PCI).

Main Results:

  • Thirty-seven patients underwent iterative CRS and HIPEC for peritoneal recurrence.
  • Pseudomyxoma peritonei was the most common indication for iterative surgery (73.0%).
  • Factors associated with worse overall survival at iterative CRS and HIPEC included incomplete cytoreduction and a PCI >20.

Conclusions:

  • Iterative CRS and HIPEC is a safe and effective treatment option for selected patients with recurrent PSM.
  • Favorable survival can be achieved with low morbidity in well-selected patients undergoing repeat procedures.
  • Completeness of cytoreduction and PCI are critical prognostic factors influencing overall survival.