Perioperative outcomes of cytoreductive surgery and perioperative intraperitoneal chemotherapy for non-appendiceal peritoneal carcinomatosis from a prospective database.
BACKGROUND
Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy has expanded its application in the management of peritoneal carcinomatosis from gastrointestinal and ovarian malignancies. An accurate assessment of perioperative outcomes is crucial for integration of this combined procedure into clinical practice.


METHODS
A prospective study of 80 patients undergoing the combined treatment for non-appendiceal peritoneal carcinomatosis was conducted. Forty-seven adverse events by eight organ-systems were rated from Grade I to IV with increasing severity.


RESULTS
One patient (1.3%) died postoperatively. Postoperative adverse events affected genitourinary system (38%), hematological system (31%), gastrointestinal system (25%), infection (20%), intravenous catheters status (15%), pulmonary system (14%), cardiovascular system (11%) and neurological system (4%). Thirty-six patients (45%) experienced 49 Grade III adverse events. Six patients (8%) experienced eight Grade IV adverse events. More than four peritonectomy procedures (P = 0.010), and length of hospital stay of more than 21 days (P = 0.007) were strongly associated with Grade III and/or Grade IV morbidity.


CONCLUSIONS
The morbidity and mortality rates after the combined treatment for non-appendiceal peritoneal carcinomatosis were within the acceptable range of surgical treatments for other gastrointestinal cancers. A standardized prospective database is required for an accurate assessment of perioperative outcomes.
Yan
Tristan D
TD
Peritoneal Surface Malignancy Program, Washington Cancer Institute, Washington Hospital Center, Washington, District of Columbia 20010, USA.
Zappa
Luis
L
Edwards
Gary
G
Alderman
Robert
R
Marquardt
Christina E
CE
Sugarbaker
Paul H
PH
D002277:Carcinoma / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D019990:Perioperative Care / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D010537:Peritoneum / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors