Surgical and survival outcomes of cytoreductive surgery alone or with perioperative intraperitoneal chemotherapy in high peritoneal cancer index
Metin Ercan1
, Mehmet Aziret2, Kerem Karaman2, Osman Köse3, Volkan Öter4, Hakan Yırgın2, Ahmet Kaya1, Yavuz Selim Kahraman1, Elif Köse5, Erdal Birol Bostancı4, Orhan Ünal6
1Department of Surgical Oncology, Sakarya University Faculty of Medicine, Sakarya, Türkiye
2Department of Gastroenterological Surgery, Sakarya University Faculty of Medicine, Sakarya, Türkiye
3Department of Gynecological Oncology Surgery, Sakarya University Faculty of Medicine, Sakarya, Türkiye
4Clinic of Gastroenterological Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
5Department of Public Health, Sakarya University Faculty of Medicine, Sakarya, Türkiye
6Department of Gynecological Oncology Surgery, Yeditepe University Faculty of Medicine, İstanbul, Türkiye
Abstract
Objective: The aim of this study was to examine the early surgical and long-term survival outcomes of cytoreductive surgery (CRS) alone and CRS plus perioperative intraperitoneal chemotherapy (IPC) in patients with peritoneal metastases (PM).
Material and Methods: CRS alone or CRS plus IPC was performed on 122 patients for various intraabdominal PMs. Patients were divided into two groups as PCI ≤19 and PCI >19 to compare early surgical outcomes.
Results: Among PM patients 70 (57.4%) were of non-ovarian and 52 (42.6%) were of ovarian origin. Of the patients 74 (60.7%) were in the peritoneal cancer index (PCI) ≤19 group and 48 (39.3%) were in the PCI >19 group. The complication ratio of PCI >19 group was higher than that of the PCI ≤19 group and median overall survival (OS) of PCI >19 group was lower than that of the PCI ≤19 group. Complete or nearly complete (CCR-0/CCR-1) resections rates were similar in both groups (95.9% in the PCI ≤19 group and 93.8% in the PCI >19 group). However, CCR-0 resection rate was found to be lower in the PCI >19 group compared to the PCI ≤19 group (60.8% vs. 39.6%) (p <0.001).
Conclusion: CCR-0/CCR-1 resections can be achieved with CRS in most patients with PCI >19 score. It would be appropriate to consider CRS or CRS plus perioperative IPC for palliative purposes in selected patients with PCI >19 score.
Keywords: Peritoneal metastases, peritoneal cancer index, cytoreductive surgery, early post-operative intraperitoneal chemotherapy, hyperthermic intraperitoneal chemotherapy
Cite this article as: Ercan M, Aziret M, Karaman K, Köse O, Öter V, Yırgın H, et al. Surgical and survival outcomes of cytoreductive surgery alone or with perioperative intraperitoneal chemotherapy in high peritoneal cancer index. Turk J Surg 2024; 40 (3): 219-228
This study was approved by the Clinical Research Ethics Committee of Sakarya University Faculty of Medicine (Decision no: E-71522473-050.01.04-83248-96, Date: 30.11.2021).
Extarnally peer-reviewed.
Concept - ME, MA; Design - KK, ME; Supervision - OÜ, EBB; Materials - EK, OK, OÜ, EBB: Data Collection and/or Processing - MA, HY, YSK; Analysis and/or Interpretation - MA, KK; Literature Search - ME, VÖ, MA, OS; Writing Manuscript - ME, MA, VÖ; Critical Reviews - OÜ, EBB.
The authors declare that they have no conflict of interest.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.