title: Clinical Outcomes of Patients with Extensive Peritoneal Carcinomatosis Following Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy.
abstract: OBJECTIVE
  The aims of this study were to explore clinical outcomes and assess the learning curve for cytoreductive surgery and perioperative intraperitoneal chemotherapy (PIC) for patients with a high peritoneal cancer index (PCI).
  
  
  METHODS
  This was a retrospective study of patients with a PCI of 20 or more following CRS and PIC. Outcomes in five successive groups based on the operation date were analyzed.
  
  
  RESULTS
  Three hundred and five patients were included in the study. The median overall survival (OS) was 89.3 months (95% confidence interval=58.9-107.6 months). OS at 1, 3 and 5 years of our study cohort was 89.4%, 70.4% and 57.5%, respectively. In terms of the learning curve, the mean duration of operation and hospital mortality decreased (p<0.001 and p=0.006 respectively). A trend for decreasing intensive care unit stay (p=0.497), high dependency unit stay (p=0.042) and total hospital stay (p=0.202) were also recorded.
  
  
  CONCLUSIONS
  A high PCI alone should not be a contraindication for cytoreductive surgery and PIC in specialized centres.
authors.affiliation: Department of Surgery, University of New South Wales, St George Hospital, Sydney, NSW, Australia.
authors.forename: Yeqian
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Surgery, University of New South Wales, St George Hospital, Sydney, NSW, Australia College of Medicine, Imam Muhammad ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia nayefalhariri@hotmail.com.
authors.forename: Nayef A
authors.initials: NA
authors.lastname: Alzahrani
authors.affiliation: Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia.
authors.forename: Terence C
authors.initials: TC
authors.lastname: Chua
authors.affiliation: Department of Surgery, University of New South Wales, St George Hospital, Sydney, NSW, Australia.
authors.forename: Ya Ruth
authors.initials: YR
authors.lastname: Huo
authors.affiliation: Department of Surgery, University of New South Wales, St George Hospital, Sydney, NSW, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000401:mortality / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007263:Infusions, Parenteral; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Peritoneal cancer index; cytoreductive surgery; perioperative intraperitoneal chemotherapy