Improving management of colorectal peritoneal carcinomatosis by hyperthermic intraperitoneal chemotherapy: OP05

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Aim:Peritoneal carcinomatosis (PC) is a common manifestation of advanced malignancy, associated with a badprognosis. There is increasing interest in hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgical cytoreduction (SC). We report our experience of the management of peritoneal carcinomatosis, focusing on colorectal malignancy.Method:Retrospective study of all operative management of PC by SC-HIPEC from 1996 to 2009.Results:During this period, 60 surgical explorations for PC were performed. Complete SC was impossible in 9. Median age of the 51 resected patients (34F, 17M), was 50 (17-66). Primary cancers were 32% pseudomyxomas, 25% colorectal, 22% ovarian, 17% gastric and 4% mesotheliomas. Severe complication rate (grade III-IV) was of 39%; reoperation occured in 20% (three anastomotic leaks, four perforations); perioperative mortality (D60) was 2% (n = 1); median hospital stay was 30 days (12-105). Median follow-up was 18 months (1-196), with an overall survival rate of 80%. Colorectal disease showed a better survival than non colorectal malignancies (100% of survival in pseudomyxoma and 86% in adenocarcinoma)Conclusion:SC-HIPEC has aprofound impact on theprognosis of colorectal peritoneal carcinomatosis with better survival than for other malignancies. In this context, the high observed morbidity appears acceptable.

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