title: Cytoreduction with hyperthermic intraperitoneal chemotherapy: an appraisal of outcomes and cost at a newly established peritoneal malignancy program.
abstract: BACKGROUND
  Outcome measures after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for peritoneal carcinomatosis in established centers are well defined. However, results from newly emerging US centers have not been reported.
  
  
  METHODS
  This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC.
  
  
  RESULTS
  Fifty-six patients underwent exploratory laparotomy with 36 receiving CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18, and the cytoreduction 0/1 rate was 92%. Postoperative major morbidity was 16.7% with one perioperative death. The median length of hospital stay and intensive care unit days were 9 and 3 days, respectively. Disease-free survival in high-grade vs low-grade tumors was 12.6 and 31.0 months (P, .03), respectively. Average direct cost for patients undergoing CRS/HIPEC was $25,917.
  
  
  CONCLUSIONS
  Our emerging center's short-term results are comparable with established programs with a trend toward more selective intraoperative judgment on who undergoes CRS/HIPEC.
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Hinkle
authors.affiliation: College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: James
authors.initials: J
authors.lastname: MacDonald
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Sharpe
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Paxton
authors.initials: P
authors.lastname: Dickson
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Deneve
authors.affiliation: Western Michigan University Homer Stryker School of Medicine/West Michigan Cancer Center, 200 North Park Street, Kalamazoo, MI 49001, USA. Electronic address: gmunene.md@gmail.com.
authors.forename: Gitonga
authors.initials: G
authors.lastname: Munene
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cost; Cytoreduction; Cytoreductive surgery; HIPEC; Hyperthermic intraperitoneal chemotherapy