title: Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival in selected patients with peritoneal carcinomatosis from abdominal and pelvic malignancies: results of 21 cases.
abstract: We evaluated the perioperative safety profile and efficacy of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in 21 patients with peritoneal carcinomatosis (PC) from gastrointestinal and gynecological cancers. Twenty-one patients with PC (12 gastric cancer, 5 colorectal cancer, 2 ovarian cancer, 1 pseudomyxoma peritonei, 1 malignant mesothelioma) were treated with CRS + HIPEC with hydroxycamptothecin 20 mg and mitomycin C 30 mg in 12,000 mL of normal saline at 43 +/- .5 degrees C for 60 to 90 minutes. Vital signs were recorded for 5 days after surgery. We analyzed the following: local and systemic infections; gastrointestinal function recovery; hematological, hepatic, and renal parameters; wound healing time; adverse events; survival; and quality of life. The PC index was 2 to 33 (median, 11), the duration of operation 4 to 10 h (median, 8 h), and the highest temperature during 5 postoperative days 38.1 degrees C. Two patients developed generalized edema and were successfully treated. Five patients developed hypoproteinemia on day 1 after surgery. All routine blood tests checked at 1 week after surgery were normal. Time of gastric tube removal was 2 to 7 days. Liquid food intake time was 3 to 8 days. Time of removal of stitches was 8 to 18 days. No local or systemic infections, wound disruption, or other clinically important adverse events occurred. The follow-up was 8 to 43 months (median, 22.5 months). Eleven patients died, three survived with tumor, and seven survived free of tumor. CRS + HIPEC was well tolerated in our selected patients with PC, some of whom had improved survival.
authors.affiliation: Department of Oncology, Zhongnan Hospital, Cancer Center of Wuhan University, Hubei Cancer Clinical Study Center, Wuchang District, China.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Alaa Hammed
authors.initials: AH
authors.lastname: al-shammaa Hassan
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Yang
authors.forename: Shao-Yang
authors.initials: SY
authors.lastname: Liu
authors.forename: Yu-Lan
authors.initials: YL
authors.lastname: Lu
authors.forename: Jing-Wei
authors.initials: JW
authors.lastname: Zhang
authors.forename: Yukata
authors.initials: Y
authors.lastname: Yonemura
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000628:therapy; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008654:Mesothelioma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000628:therapy*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate
chemical_list: D016685:Mitomycin; D002166:Camptothecin