PTH-351 Cytoreductive surgery and heated intraperitoneal chemotherapy: safety and feasibility of a newly established uk peritoneal malignancy unit. (22nd June 2015)

• Record Type: Journal Article
• Authors: Shariff, U; Seretis, C; Ali, A; Veerabadran, S; Raju, T; Browse, D; Youssef, H
• Is Part Of: Gut. Volume 64(2015)Supplement 1
• Page Start: A563
• Page End: A563
• Publication Date: 2015-06-22
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2015-309861.1237
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: Cytoreductive Surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) is a radical strategy for the treatment of disseminated intra-abdominal cancers. 1 Complete cytoreduction combines multiple visceral and peritoneal resections to achieve macroscopic intra-abdominal tumour clearance. Combined with HIPEC, this aims to destroy residual microscopic tumour. We report the results of this technique and early survival data in a newly established UK Peritoneal Malignancy Unit, by a team trained to deliver the service. Method: For all patients undergoing peritoneal surgery (November 2011–February 2015) data was prospectively collected on demographics, severity of disease (Peritoneal Carcinomatosis Index-PCI), surgery undertaken, pathology, operating time, intra-operative blood loss, intensive care unit (ITU) stay, length of stay (LOS), completeness of cytoreduction (CC) and postoperative morbidity/mortality. Results: Of 49 patients operated on, Complete Cytoreduction was achieved in 41 patients (84%) (CC0–37: CC1–4: CC2–8) (median age 56 years, range 29–79). The pathology included were: 29 colorectal cancers (7 primary, 22 recurrent), 8 appendiceal adenocarcinoma, 3 ovarian tumours, 9 others. Of the 41/49 CC0/1 patients, median PCI was 9 (0–29); median intra-operative time 9 h (4–12), median blood loss 1L (0–2.5L); median ITU stay: 4 days (1–11); median LOS: 16 days (5–75). Grade 3/4 (CTCAEv3) complications occurred in 15 patients (34%). 1 patient (2.2%) returned to theatre and there was no post-operative mortality. Median follow-up was 11.4 months (range 1.5–36.4). Kaplan-Meier predicted 1-year survival was 81% and 2-year survival was 68%. Conclusion: Results from our unit demonstrate that CRS/HIPEC can be performed safely by a team trained to deliver the service. Medium-term survival rates are acceptable, in patients who would have traditionally been considered as terminal, with 68% surviving 2 years. Morbidity rates are high, but with careful case selection and aggressive treatment of post-operative complications, there was no postoperative mortality in this series. Disclosure of interest: None Declared. Reference: Esquivel J, Sticca R, Sugarbaker P, et al . Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: A consensus statement. Ann SurgOncol. 2007;14:128–133