title: Reoperation combining re-cytoreductive surgery and re-HIPEC for recurrent peritoneal carcinomatosis.
abstract: OBJECTIVE
  Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the proper treatment for resectable peritoneal carcinomatosis (PC). The aim of this study was to evaluate the postoperative course and long-term outcome of repeat CS (reCS) plus repeat HIPEC (reHIPEC) in patients with recurrent disease, after primary CS plus primary HIPEC.
  
  
  METHODS
  From 2004 to 2012 85 patients were subjected to primary CS + HIPEC. Fourteen of those patients developed recurrent PC and were subjected to reCS+reHIPEC during the same time period. Eligibility criteria included limited extent of the peritoneal disease, and interval of more than 12 months from the primary CS+HIPEC. The origins of the tumors were ovarian cancer (n=7) colorectal cancer (n=3), pseudomyxoma peritonei (n=3), and uterine sarcoma (n=1).
  
  
  RESULTS
  At second laparotomy, mean peritoneal cancer index (PCI) was 5.3 + 2.8. Among the 14 procedures, HIPEC was used in all patients. The postoperative mortality was 0% and grade 3-4 postoperative complications occurred in 4 patients. The overall 1-, 2- and 3- year overall survival rate was 90, 40 and 30%, respectively.
  
  
  CONCLUSIONS
  ReCS+reHIPEC is feasible and yields an accepted survival in highly selected patients.
authors.affiliation: Department of Surgery, "Metaxa" Cancer Hospital, Piraeus, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Spiliotis
authors.forename: A
authors.initials: A
authors.lastname: Vaxevanidou
authors.forename: E
authors.initials: E
authors.lastname: Halkia
authors.forename: G
authors.initials: G
authors.lastname: Hadjigeorgiou
authors.forename: A
authors.initials: A
authors.lastname: Datsis
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000628:therapy*; D012086:Reoperation; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents