Morbidity and mortality in a series of patients suffering from intraperitoneal neoplasia treated with peritoneal cytoreduction and hyperthermic intraperitoneal chemotherapy at the Fundación Santa Fe de Bogotá Teaching Hospital (ONCOLGroup - ATIA study) [Morbilidad y mortalidad en una serie de pacientes con neoplasias del peritoneo, tratados con citorreducción peritoneal más quimioterapia hipertérmica intraperitoneal en el Hospital Universitario de la Fundación Santa Fe de Bogotá (ONCOLGroup - estudio ATIA)]
Arias F.,Fundacion Santa Fe de Bogota |
Arias F.,University of Los Andes, Colombia |
Otero J.M.,Grupo Enfermedades del Peritoneo |
Otero J.M.,Santa Fe Institute |
And 15 more authors.
Revista de Gastroenterologia de Mexico | Year: 2012
Background: The procedure of radical peritonectomy followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is considered the standard treatment for peritoneal cancers. Aims: To evaluate various outcomes in a cohort of patients with peritoneal tumors treated with HIPEC. Methods: Twenty-four patients consecutively treated with radical peritonectomy plus HIPEC within the time frame of November 2007 to July 2010 were enrolled; 15 (62%) had tumors of appendicular origin, 4 (16.7%) had primary peritoneal tumors, 2 had ovarian carcinomas and there was one case of colon cancer, one carcinosarcoma and one hemangioendothelioma. Mean age was 53 years (range: 26-68) and median follow-up was 14.2 months (range: 1-32). Demographic data, histology, peritoneal cancer index (PCI), surgical procedure characteristics, recurrence-free survival (RFS), and overall survival (OS) were all evaluated. Short-term morbidity and mortality were also determined. Results: Complete cytoreduction was achieved in 18 patients (75%). Mean PCI was 15 (10: 41% and 10: 58%), and the median (range) for surgery duration, lenght of stay in the Intensive Care Unit, parenteral nutritional support, and hospital stay were 12,5 (7-20) hours, 11,4 (2-74) days, 13,8 (12-65) days, and 29,1 (10-90) days, respectively. One patient (4%) died 6 months after the procedure, due to multiple associated complications. Considerable morbidity was seen in 52% of cases, including thromboembolic events (41%), catheter-related bacteremia (29%), fistulas (29%), and nephrotoxicity (25%). Six patients (25%) recurred after a median of 21 months of RFS. Conclusions: Cytoreductive surgery plus HIPEC in well-selected patients presenting with tumors that affect the peritoneum is a procedure that can be carried out in Colombia with an adequate safety and effectiveness profile. Mortality was similar to that reported in the international literature. © 2011 Asociación Mexicana de Gastroenterología.