Search

Objective: The aim of this research was to assess the perioperative outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancers and evaluate the factors having impacts on morbidity and mortality. Design: This was a prospective, single-institutional study. Materials and Methods: The study included all patients undergoing CRS and HIPEC from November 1, 2014 to December 31, 2015, at the Rajiv Gandhi Cancer Institute and Research Centre, in New Delhi, India. Patient characteristics, disease factors, and operative outcomes were analyzed using descriptive statistics, and the impact of these variables on perioperative outcomes was evaluated using a Chi-square test. Results: Twenty-five patients, with mean age, body mass index, and body surface area of 48.7 years, 24.8kg/m2, and 1.592 m2, respectively, underwent primary (32%) or secondary (68%) CRS with HIPEC at a mean temperature of 42.5°C for 90 minutes. On average, time to oral feeds, intensive-care unit stay, and hospital stay were 3.96, 5.04, and 7.96 days, respectively. Major morbidity (Common Toxicity Criteria for Adverse Events grades 3-5) was seen in 5 patients and was significantly higher in patients aged >50 years ( p = 0.040) or with other comorbidities ( p = 0.044). Minor complications, including all chemotherapy-related complications, were seen in 36% patients with a slightly higher risk in suboptimally debulked patients. Two patients succumbed to disease in the perioperative period and were seen to have significantly longer surgeries ( p = 0.045). No other parameters were seen to affect the perioperative outcomes. Conclusions: CRS with HIPEC is feasible and safe for advanced and recurrent ovarian cancer. Patient's age, comorbidity, and surgery duration affect perioperative outcomes and may be used to define selection criteria for HIPEC. (J GYNECOL SURG 33:4) [ABSTRACT FROM AUTHOR]

Objective: This prospective study aimed to see long-term oncological outcome of Transoral Robotic Surgery as single modality treatment for cT1-T2 N0 HPV negative oropharyngeal malignancies.Method: From March 2013 to October 2015, 57 patients with early stage oropharyngeal carcinoma underwent Transoral robotic surgery (TORS) with neck dissection using daVinci® Surgical system. Patients were evaluated for disease free survival, overall survival, locoregional and distant metastasis.Results: 57 patients (48 males and 9 females) underwent TORS for early stage oropharyngeal carcinoma. All patients underwent ipsilateral neck dissection and 12 patients underwent bilateral neck dissection. 49 patients with final histopathology suggestive of stage I and II disease did not received any adjuvant treatment. Mean age at presentation was 59.4years (37-88years). Most common site of involvement was the base of tongue (BOT) in 31 (54.8%) patients. Twenty-four (42.1%) patients were cT1 and 33 (57.9%) were cT2 at presentation. During follow-up, 2 (4.2%) patients recurred locoreginally and 1 (2.1%) patient had distant metastasis. Two patients expired due to causes other than malignancy. Forty-three (89.6%) patients were disease free on an average follow-up of 29months with an overall survival of 93.8% at mean follow-up of 29months.Conclusion: Transoral Robotic Surgery as a single modality treatment is a good option for cure in HPV negative early resectable oropharyngeal malignancies which are relatively unresponsive to radiation. TORS can be used to de-intensify the treatment of early stage oropharyngeal carcinoma and thus avoid the early and late toxicities associated with Radiotherapy/Chemoradiotherapy. [ABSTRACT FROM AUTHOR]