Brief Article
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World J Gastroenterol. May 7, 2012; 18(17): 2061-2066
Published online May 7, 2012. doi: 10.3748/wjg.v18.i17.2061
Experience after 100 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Ingmar Königsrainer, Derek Zieker, Jörg Glatzle, Olivia Lauk, Julia Klimek, Stephan Symons, Björn Brücher, Stefan Beckert, Alfred Königsrainer
Ingmar Königsrainer, Derek Zieker, Jörg Glatzle, Olivia Lauk, Julia Klimek, Björn Brücher, Stefan Beckert, Alfred Königsrainer, Department of Surgery, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany
Stephan Symons, Center for Bioinformatics Tübingen, Sand 14, D-72076 Tübingen, Germany
Author contributions: Königsrainer I wrote the paper and designed the study; Beckert S helped to write the paper and contributed to the design; Zieker D and Glatzle J contributed to the design, analysis of the study; Brücher B helped designing the study; Symons S analyzed data; Lauk O and Klimek J helped with study design and literature search; Königsrainer A helped writing the paper, designed the study and approved the final version of the manuscript.
Correspondence to: Ingmar Königsrainer, MD, Department of Surgery, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. ingmar.koenigsrainer@med.uni-tuebingen.de
Telephone: +49-7071-2985073 Fax: +49-7071-295588
Received: December 9, 2011
Revised: February 6, 2012
Accepted: February 16, 2012
Published online: May 7, 2012
Abstract

AIM: To investigate perioperative patient morbidity/mortality and outcome after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

METHODS: Of 150 patients 100 were treated with cytoreductive surgery and HIPEC and retrospectively analyzed. Clinical and postoperative follow-up data were evaluated. Body mass index (BMI), age and peritoneal carcinomatosis index (PCI) were chosen as selection criteria with regard to tumor-free survival and perioperative morbidity for this multimodal therapy.

RESULTS: CRS with HIPEC was successfully performed in 100 out of 150 patients. Fifty patients were excluded because of intraoperative contraindication. Median PCI was 17 (1-39). In 89% a radical resection (CC0/CC1) was achieved. One patient died postoperatively due to multiorgan failure. Neither PCI, age nor BMI was a risk factor for postoperative complications/outcome according to the DINDO classification. In 9% Re-CRS with HIPEC was performed during the follow-up period.

CONCLUSION: Patient selection remains the most important issue. Neither PCI, age nor BMI alone should be an exclusion criterion for this multimodal therapy.

Keywords: Peritoneal carcinomatosis; Single-center experience; Hyperthermic intraoperative chemotherapy; Complications; Risk assessment; Selection criteria