1. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis: initial experience in Oaxaca, Mexico.
- Author
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García-Matus R, Hernández-Hernández CA, Leyva-García O, Vásquez-Ciriaco S, Flores-Ayala G, Navarro-Hernández Q, Pérez-Bustamante G, Valencia-Mijares NM, and Esquivel J
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma mortality, Carcinoma pathology, Combined Modality Therapy, Female, Gastrointestinal Neoplasms drug therapy, Gastrointestinal Neoplasms mortality, Gastrointestinal Neoplasms pathology, Gastrointestinal Neoplasms surgery, Humans, Length of Stay statistics & numerical data, Male, Mexico, Middle Aged, Neoplasm Recurrence, Local, Ovarian Neoplasms drug therapy, Ovarian Neoplasms mortality, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery, Peritoneal Neoplasms mortality, Peritoneal Neoplasms pathology, Survival Rate, Treatment Outcome, Carcinoma drug therapy, Carcinoma surgery, Chemotherapy, Cancer, Regional Perfusion methods, Hyperthermia, Induced, Peritoneal Neoplasms drug therapy, Peritoneal Neoplasms surgery
- Abstract
Peritoneal carcinomatosis (PC) has been traditionally considered a terminal disease with median survivals reported in the literature of 6 to 12 months. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) are playing an ever increasing role in the treatment of these patients. Excellent results have been achieved in well-selected patients but there is a very steep learning curve when starting a new program. A program for peritoneal surface malignancies in which patients with PC of gastrointestinal or gynecological origin were treated using multimodality therapy with combinations of systemic therapy, cytoreductive surgery (CRS), and HIPEC was initiated in December 2007 at "Hospital Regional de Alta Especialidad de Oaxaca," Mexico. We present the results of our initial experience. From December 2007 to February 2011, 26 patients were treated with CRS and HIPEC. There were 21 female patients. Most common indication (46%) was recurrent ovarian cancer. Mean duration of surgery was 260 minutes. Mean Peritoneal Cancer Index was 9. Twenty-three (88.5%) patients had a complete cytoreduction. Major morbidity and mortality rates were 19.5 and 3.8 per cent, respectively. Mean hospital stay was 8 days. At a mean follow-up of 20 months, median survival has not been reached. Rigorous preoperative workup, strict selection criteria, and mentoring from an experienced cytoreductive surgeon are mandatory and extremely important when starting a center for PC.
- Published
- 2012