title: Clinical course for patients with peritoneal carcinomatosis excluded from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
abstract: BACKGROUND
  Cytoreductive surgery combined with 'Hyperthermic IntraPEritoneal Chemotherapy' (HIPEC) represents the only potentially curative treatment available for carcinomatosis secondary to colorectal cancer (CRC), pseudomyxoma peritonei (PMP), malignant peritoneal mesothelioma (MM) and goblet cell carcinoma (GCC). Despite preoperative investigation some patients are excluded perioperatively because of unacceptably massive tumor extent. The data available on the clinical course of these patients are sparse. The aim of this study was to investigate mortality, morbidity and clinical course for patients who were excluded.
  
  
  METHODS
  This was a retrospective observational study based on records from 35 patients (21 men, 14 women) treated in a national center (Surgical Department P, Aarhus University Hospital) from June 2006 to August 2011 and excluded from the cytoreductive surgery perioperatively. The study population included patients aged 18 to 70 years with CRC (n = 19), PMP (n = 11), MM (n = 3) or GCC (n = 2). Vital status was obtained by 29 November 2012. Three patients were lost to follow-up.
  
  
  RESULTS
  The 30-day mortality rate was 0%. Postoperative complications within 30 days occurred in three patients (9.4%). In all, 19 patients (54%) had palliative surgery during exploratory laparotomy. In total, 28 patients (88%) received postoperative palliative chemotherapy. The median survival for CRC and PMP patients was 12.7 (95% CI 4.0 to 21.4) and 26.9 (95% CI 25.7 to 28.1) months, respectively.
  
  
  CONCLUSIONS
  Exploratory laparotomy for intended curative treatment of peritoneal carcinomatosis did not imply major morbidity or mortality for patients excluded from treatment due to advanced stage of disease.
authors.affiliation: Department of Surgery P, Aarhus University Hospital, Tage Hansens Gade 2, Aarhus DK-8000, Denmark. anne.p.rodt@gmail.com.
authors.forename: Anne Peen
authors.initials: AP
authors.lastname: Rodt
authors.forename: Rebekka Oxenvad
authors.initials: RO
authors.lastname: Svarrer
authors.forename: Lene Hjerrild
authors.initials: LH
authors.lastname: Iversen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
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