title: Clinical history of patients with peritoneal carcinomatosis exluded from cytoreductive surgery & HIPEC.
abstract: OBJECTIVE
  The aim of this study was to explore the natural course of peritoneal carcinomatosis (PC) in patients who are not fit to undergo cytoreductive (CRS) surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).
  
  
  METHODS
  Over an 8-year period (2006-2013) 320 patients were excluded from CRS and HIPEC at our center. Exclusion criteria were: (a) age >75 years; (b) ASA score ≥ 3; (c) extraperitoneal disease; (d) massive disease involvement of the small bowel; (e) disease involvement of the hepatic pedicle or the pancreas; (f) invasion of retroperitoneal space; (g) more than two stenoses of the small bowel. Another 130 patients underwent CRS and HIPEC.
  
  
  RESULTS
  In the HIPEC group (N=130), the mean overall survival was 26.2±11.7 months, while from the non- HIPEC group (N=320), 200 patients underwent palliative surgery, with a mean overall survival of 11.7±8.3 months. Only 120 patients received palliative chemotherapy with a mean overall survival of 7.2±4.3 months.
  
  
  CONCLUSIONS
  Our study suggests that, in patients unfit to undergo CRS & HIPEC, an exploratory laparotomy and palliative surgery should be performed, offering a survival benefit and improved quality of life.
authors.affiliation: 1st Department of Surgical Oncology, Metaxa Cancer Hospital, Piraeus, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Spiliotis
authors.forename: Evgenia
authors.initials: E
authors.lastname: Halkia
authors.forename: Athanassios
authors.initials: A
authors.lastname: Rogdakis
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Kastrinaki
authors.forename: Evangelos
authors.initials: E
authors.lastname: Lianos
authors.forename: Elias
authors.initials: E
authors.lastname: Efstathiou
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D000075202:Contraindications; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006115:Greece; D006801:Humans; D007036:Hypothermia, Induced; D053208:Kaplan-Meier Estimate; D008297:Male; D010166:Palliative Care / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011788:Quality of Life; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents