Related Experiment Video
Updated: Jan 8, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal malignancy-outcomes and learning curves in
N Algethami1,2, V Valdimarsson3,4, H Thorlacius3,4
1Section of Surgery Department of Clinical Sciences Malmö, Lund University Inga-Marie Nilssons gata 47 205 02 Malmö Sweden.
Introduction:
Implementing new treatment regimens entails a learning phase with a concomitant risk of suboptimal results. High caseload has generally been shown to improve results in complex surgical procedures. This study aimed to evaluate results of Cytoreductive Surgery (CRS) and Intraperitoneal Chemotherapy (IP), given as Early Postoperative Intraperitoneal Chemotherapy (EPIC) or Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in a mid-size volume center, stratified by time periods.
Method:
This retrospective single-center cohort study included all CRS-IP procedures in Malmö, Sweden. All data were retrieved from a prospective quality control registry. Primary outcomes were: 5-year overall survival (5-Yr OS) and 30-day severe and total postoperative complication rates. Secondary outcomes were: recurrence rate, 3-year disease-free survival (DFS), and 90-day mortality rate. Outcomes were analyzed by time periods divided into initiating phase (n = 56) and established phase (n = 208).
Results:
In total 264 CRS-IP in 240 patients were performed from 2004 to 2021 (35 EPIC, 229 HIPEC). The 5-Yr OS after primary CRS-IP was 43% in colorectal cancer (n = 169) and 87% in pseudomyxoma (n = 53). In pmCRC, the 5-year OS was significantly lower in the initiation phase (29%) compared to the established phase (48%), verified in an adjusted multivariable analysis showing a hazard ratio of 0.51 for mortality in the established phase. The risk of recurrence did however not differ. Total 30-day complication rate was 67%, severe complication rate 15% and 90-day mortality was 1%. None of which differed depending on time period in multivariable analysis.
Conclusion:
Our results for both pseudomyxoma peritonei (PMP) and pmCRC are in line with previously published results, implying that high volume is not a prerequisite for high-quality CRS-IP. Although long-term survival in pmCRC was significantly better in the established phase, recurrence rates remained unchanged. Further, postoperative mortality and risk of complications did not differ between time periods, suggesting that the impact of the learning curve was limited.
More Related Videos
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
09:48An Orthotopic Endometrial Cancer Model with Retroperitoneal Lymphadenopathy Made From In Vivo Propagated and Cultured VX2 Cells
Published on: September 12, 2019