Peritoneal carcinomatosis treated with cytoreductive surgery and intraperitoneal chemotherapy
| Autor: | Magda Maria Profeta da Luz, Mônica Maria Demas Álvares Cabral, Leonardo Maciel da Fonseca, Rodrigo Gomes da Silva, Bernardo Hanan, Antônio Lacerda-Filho |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Colorectal cancer medicine.medical_treatment RC799-869 Intraperitoneal chemotherapy 03 medical and health sciences Pseudomixoma peritoneal 0302 clinical medicine medicine Pseudomyxoma peritonei Cytoreductive surgery Mesothelioma Quimioterapia intraperitoneal Cancer colorretal Univariate analysis business.industry Carcinomatose peritoneal Mortality rate Mitomycin C Gastroenterology Diseases of the digestive system. Gastroenterology medicine.disease Surgery 030220 oncology & carcinogenesis Hyperthermic intraperitoneal chemotherapy business Cirurgia citorredutora Peritoneal carcinomatosis 030215 immunology |
| Zdroj: | Journal of Coloproctology (Rio de Janeiro) v.38 n.2 2018 Journal of Coloproctology (Rio de Janeiro. Online) Sociedade Brasileira de Coloproctologia (SBCP) instacron:SBCP Journal of Coloproctology (Rio de Janeiro), Volume: 38, Issue: 2, Pages: 172-178, Published: JUN 2018 Journal of Coloproctology, Vol 38, Iss 2, Pp 172-178 (2018) |
| Popis: | Introduction: To evaluate the combined treatment with cytoreductive surgery and intraperitoneal chemotherapy for peritoneal carcinomatosis arising from colorectal cancer, pseudomyxoma peritonei and mesothelioma. Methods: Data were obtained from 73 patients with peritoneal carcinomatosis arising from colorectal cancer (52.1%), pseudomyxoma peritonei (41.1%) or mesothelioma (6.8%) between 2002 and 2011. We reported the morbidity grade (II, III and IV), mortality and survival rates of the candidates after cytoreductive surgery and intraperitoneal chemotherapy. Results: 41 (56.2%) women participated, and the median age was 50 years. Thirty-nine patients (53.4%) underwent complete cytoreductive surgery and intraperitoneal chemotherapy. Patients who underwent a complete cytoreduction received intraperitoneal chemotherapy with mitomycin C, from which only 16/39 (41%) had hyperthermic intraperitoneal chemotherapy (41–42 °C). The overall morbidity rate was 23.3% and the grade III/IV complication rate was 12.3%. The overall mortality rate was 5.5%. The univariate analysis showed that cytoreductive surgery and intraperitoneal chemotherapy (p = .029), a blood transfusion (p = .002) and the operative time (p = .001) were significant for the occurrence of postoperative complications. Patients with peritoneal carcinomatosis from colorectal cancer who underwent complete cytoreductive surgery and intraperitoneal chemotherapy had overall survival rates of 81.3%, 12.5% and 12.5% at 1, 3 and 5 years, respectively. Patients with peritoneal carcinomatosis from pseudomyxoma peritonei who underwent complete cytoreductive surgery and intraperitoneal chemotherapy had overall survival rates of 84.2%, 77.7% and 77.7% at 1, 3 and 5 years, respectively. Conclusion: The combined treatment for peritoneal carcinomatosis may be performed safely with acceptable morbidity and mortality in a specialized unit setting. Although over half of patients underwent normothermic intraperitoneal chemotherapy, our results were comparable to results from others centers. Resumo: Introdução: O objetivo foi avaliar o tratamento combinado da cirurgia citorredutora e quimioterapia intraperitoneal em pacientes com carcinomatose peritoneal secundária ao câncer colorretal, pseudomixoma peritoneal e mesotelioma. Métodos: Foram obtidos dados de 73 pacientes com carcinomatose peritoneal secundária ao cirurgia citorredutora (52.1%), pseudomixoma peritoneal (41,1%) ou mesotelioma (6,8%). Foram avaliados o grau de morbidade, a taxa de mortalidade e as taxas de sobrevida após a cirurgia citorredutora e quimioterapia intraperitoneal. Resultados: 41 (56,2%) pacientes do sexo feminino participaram, com média de idade de 50 anos. 39 pacientes (53,4%) foram submetidos a cirurgia citorredutora completa e quimioterapia intraperitoneal. Todos esses receberam Mitomicina C, sendo 16/39 (41%) quimioterapia intraperitoneal hipertérmica (41–42°C). A morbidade global foi 23,3%, com taxa de mortalidade global de 5,5%. A análise univariada mostrou que câncer colorretal e quimioterapia intraperitoneal (p = .029), transfusão sanguínea (p = .002) e tempo operatório (p = .001) foram associados com complicações pós-operatórias. Pacientes com carcinomatose peritoneal secundária ao cirurgia citorredutora submetidos a cirurgia citorredutora completa e quimioterapia intraperitoneal tiveram sobrevida global de 81,3%; 12,5% e 12,5% em 1, 3 e 5 anos, respectivamente. Os pacientes com pseudomixoma peritoneal que foram submetidos a cirurgia citorredutora completa e quimioterapia intraperitoneal tiveram sobrevida global de 84,2%; 77,7% e 77.7% em 1, 3 e 5 anos, respectivamente. Conclusão: O tratamento combinado para carcinomatose peritoneal é seguro quando realizado em centros terciários com experiência no procedimento. Embora mais da metade dos pacientes tenham sido submetidos a quimioterapia intraperitoneal normotérmica após a cirurgia citorredutora completa, os resultados podem ser comparados a de outros centros que utilizam exclusivamente a quimioterapia hipertérmica. Keywords: Cytoreductive surgery, Intraperitoneal chemotherapy, Peritoneal carcinomatosis, Colorectal cancer, Pseudomyxoma peritonei, Palavras-chave: Cirurgia citorredutora, Quimioterapia intraperitoneal, Carcinomatose peritoneal, Cancer colorretal, Pseudomixoma peritoneal |
| Databáze: | OpenAIRE |
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