P A Cascales-Campos1, V López-López2, F C Muñoz-Casares3, E Feliciangeli2, J Torres Melero4, P Barrios5, R Morales6, I Ramos5, G Ortega7, B Camps8, L González-Bayón9, P Bretcha-Boix10, J Farré-Alegre10, S González-Moreno11, J Gil2. 1. Hospital Clínico Universitario Virgen De La Arrixaca, Murcia, IMIB-Arrixaca, Murcia, Spain. Electronic address: cascalescirugia@gmail.com. 2. Hospital Clínico Universitario Virgen De La Arrixaca, Murcia, IMIB-Arrixaca, Murcia, Spain. 3. Hospital Universitario Reina Sofía, Córdoba, Andalucia, Spain. 4. Hospital Universitario De Torrecárdenas, Almería, Andalucia, Spain. 5. Hospital De Sant Joan De Espi Moises Broggi, Sant Joan De Espi, Cataluña, Spain. 6. Hospital Universitario Son Espases, Palma de Mayorca, Islas Baleares, Spain. 7. Hospital Universitario De Fuenlabrada, Madrid, Spain. 8. Hospital General Universitario, Valencia, Valencia, Spain. 9. Hospital General Universitario Gregorio Marañón, Madrid, Spain. 10. Hospital Quirón de Torrevieja, Alicante, Comunidad Valenciana, Spain. 11. MD Anderson Cancer Center, Madrid, Spain.
Abstract
BACKGROUND: The aim of this study is to report the perioperative outcomes of cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in patients ≥75 years from a Spanish multi-institutional experience. METHODS: This multi-institutional retrospectively analyzed a prospectively collected clinical data from 10 Spanish hospitals that are part of the Spanish Group Peritoneal Cancer Surgery (GECOP). We assessed postoperative morbidity rates and performed univariate and multivariate analyses of factors associated with overall (grade I-IV) and major (grade III-IV) postoperative morbidity. RESULTS: A total of 85 patients aged ≥75 years were included. Forty six postoperative adverse events were detected in 37 patients (43.5%). Twenty five complications in 20 patients (23.5%) were mild (grade I-II) and 16 complications in 12 patients (14.1%) were moderate-severe (grade III-IV). Five patients died in the first 90 days after the procedure (5.9%). After multivariate analysis, independent factors associated with postoperative complications were: PCI> 12 (OR: 4.14, 95% CI 1.22-14.12, p = 0.043) and the need for perioperative blood transfusion (OR: 14.91, 95% CI 3.87-57.46, p < 0.001). Regarding grade III-IV complications, after multivariate analysis, the presence of preoperative albumin levels <3.5 mgr/dl (OR: 9.15, 95% CI 1.38-60.57, p = 0.017), need for diaphragmatic peritonectomy procedures (OR: 11.32, 95% CI 1.40-91.32, p = 0.023) and perioperative blood transfusion (OR: 8.58, 95% CI 1.44-51.16, p = 0.018) were independent factors. CONCLUSIONS: Cytoreductive surgery and performing HIPEC by experienced groups in selected patients aged ≥75 years can be performed with morbidity and mortality similar to that described in the literature.
BACKGROUND: The aim of this study is to report the perioperative outcomes of cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in patients ≥75 years from a Spanish multi-institutional experience. METHODS: This multi-institutional retrospectively analyzed a prospectively collected clinical data from 10 Spanish hospitals that are part of the Spanish Group Peritoneal Cancer Surgery (GECOP). We assessed postoperative morbidity rates and performed univariate and multivariate analyses of factors associated with overall (grade I-IV) and major (grade III-IV) postoperative morbidity. RESULTS: A total of 85 patients aged ≥75 years were included. Forty six postoperative adverse events were detected in 37 patients (43.5%). Twenty five complications in 20 patients (23.5%) were mild (grade I-II) and 16 complications in 12 patients (14.1%) were moderate-severe (grade III-IV). Five patients died in the first 90 days after the procedure (5.9%). After multivariate analysis, independent factors associated with postoperative complications were: PCI> 12 (OR: 4.14, 95% CI 1.22-14.12, p = 0.043) and the need for perioperative blood transfusion (OR: 14.91, 95% CI 3.87-57.46, p < 0.001). Regarding grade III-IV complications, after multivariate analysis, the presence of preoperative albumin levels <3.5 mgr/dl (OR: 9.15, 95% CI 1.38-60.57, p = 0.017), need for diaphragmatic peritonectomy procedures (OR: 11.32, 95% CI 1.40-91.32, p = 0.023) and perioperative blood transfusion (OR: 8.58, 95% CI 1.44-51.16, p = 0.018) were independent factors. CONCLUSIONS: Cytoreductive surgery and performing HIPEC by experienced groups in selected patients aged ≥75 years can be performed with morbidity and mortality similar to that described in the literature.
Authors: P A Cascales-Campos; V López-López; J Torres-Melero; A Arjona; F C Muñoz-Casares; P Barrios; R Morales; F Pereira; P Bretcha-Boix; L González-Bayón; S González-Moreno; J Gil Journal: Clin Transl Oncol Date: 2019-05-02 Impact factor: 3.405
Authors: V López-López; P A Cascales-Campos; E Gil; J Arevalo; A Gonzalez; J Gil; F C Muñoz-Casares; J T Melero; P Barrios; R Morales; I Ramos; G Ortega; B Camps; L González-Bayón; P Bretcha-Boix; J Farré-Alegre; S González-Moreno; P Parrilla Journal: Clin Transl Oncol Date: 2017-08-10 Impact factor: 3.405
Authors: Raphael Shamavonian; Rohan McLachlan; Oliver M Fisher; Sarah J Valle; Nayef A Alzahrani; Winston Liauw; David L Morris Journal: J Gastrointest Oncol Date: 2019-04