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Review
. 2013 Sep;22(3):184-9.
doi: 10.1016/j.suronc.2013.06.001. Epub 2013 Jul 1.

Outcomes for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the elderly

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Free article
Review

Outcomes for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the elderly

Parissa Tabrizian et al. Surg Oncol. 2013 Sep.
Free article

Abstract

Background: Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) has gained acceptance in the treatment of peritoneal carcinomatosis (PC) with reported morbidity and mortality rates of 27-56% and 0-11% respectively VSports手机版. The safety and outcome of such major operation in the elderly remains unclear. We report our experience at a high volume tertiary center. .

Method: A total of 170 consecutive patients underwent CRS-HIPEC for peritoneal carcinomatosis between March 2007 and July 2012. Mitomycin C (88. 8%) was administered intraperitoneally at 42 °C for 90 min. Patients were categorized into two groups according to the age at the time of surgery: Group 1 (≤65 years-old) and Group 2 (>65 years-old). Differences between the groups were analyzed. Univariate and multivariate analyses were performed to identify variables associated with major morbidity V体育安卓版. .

Results: Of the 170 patients, 35 were older than 65 years. The two most common tumor sites were colorectal and appendiceal cancer. The perioperative morbidity and mortality rates in the elderly were 18. 8% and 8. 6% respectively. Gender, tumor type, estimated blood loss >400 mL, intraoperative blood transfusion, operative time >6 h, bowel anastomosis, intraoperative PCI >16, and extent of cytoreduction (Δ PCI) were not associated with major morbidity in the older group (p > 0. 05). At a median follow-up of 15. 7 months (0. 2-53 V体育ios版. 5 months), recurrence rate for colorectal/appendiceal PC at 1 year was 48. 0% in Group 1 and 44. 3% in Group 2 (p = NS). Median survival for the colorectal/appendiceal carcinomatosis patients in Group 1 (n = 81) was 29. 79 (SE 4. 7) months and in Group 2 (n = 20) was 21. 2 (SE 3. 0) months, (p = 0. 06, NS). .

Conclusion: CRS-HIPEC procedures for peritoneal carcinomatosis in the elderly demonstrate comparable perioperative outcome in well-selected patients VSports最新版本. Optimal cytoreduction was achieved in the majority of cases and survival was not significantly different from that of the younger group. .

Keywords: Cytoreductive surgery; Elderly; Hyperthermic intraperitoneal chemotherapy; Peritoneal carcinomatosis. V体育平台登录.

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