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Cirujano general
versão impressa ISSN 1405-0099
Resumo
LOPEZ-BASAVE, Horacio Noé et al. Cytoreduction and HIPEC in peritoneal carcinomatosis. Experience in the National Cancer Institute of Mexico. Cir. gen [online]. 2014, vol.36, n.3, pp.138-144. ISSN 1405-0099.
Background: The diagnosis of peritoneal carcinomatosis is associated a poor prognosis. The standard treatment is chemotherapy, with limited results. Other options need to be explored, and cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) maybe improve the results. This study evaluated safety and feasibility of CRS with HIPEC for peritoneal metastasis at the National Cancer Institute, Mexico.
Methods: In a pilot study of patients with peritoneal carcinomatosis (PC) treated with HIPEC after optimal CRS, a review was performed to evaluate safety and feasibility in a reference center.
Results: Thirty-nine patients were treated. The mean age was 55.4 years. After aggressive CRS, HIPEC was performed with cisplatin 25mg/m2/L and mitomycin C 3.3 mg/m2/L Major postoperative complications developed in 53%. No operative mortality occurred. The mean time of the surgical procedure was 7.06 hours (5-9 hours). The median of blood loss was 939 ml (100-3700 ml). The mean ICU stay was 2.7 days. The median survival was 28 months, with 32 months in patients with <20 points on the peritoneal cancer index, and 21 months for patients with index >21.
Conclusions: The results underline the safety and effi cacy of CRS and HIPEC for PC. It is feasible and benefi cial for patients in the National Cancer Institute, Mexico. The procedure has a low mortality rate and high morbidity, but is better than systemic therapy only.
Palavras-chave : Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Carcinomatosis; Morbidity; Mortality.