Effectiveness and failures of a fast track protocol after cytoreduction and hyperthermic intraoperative intraperitoneal chemotherapy in patients with peritoneal surface malignancies

Abstract Background The aim of this study was to analyze the results short term perioperative of patients with peritoneal surface malignancies undergoing cytoreduction with peritonectomy and HIPEC under a controlled fast track protocol and evaluate the factors related to the failure of implementatio...

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Published in:Surgical oncology 2016-12, Vol.25 (4), p.349-354
Main Authors: Cascales-Campos, P.A, Sánchez-Fuentes, P.A, Gil, J, Gil, E, López-López, V, Rodriguez Gomez-Hidalgo, N, Fuentes, D, Parrilla, P
Format: Article
Language:English
Subjects:
Abdomen
Blood transfusions
Cancer therapies
Chemotherapy
Chemotherapy, Cancer, Regional Perfusion
Clinical Protocols - standards
Combined Modality Therapy
Cytoreduction Surgical Procedures - methods
Failure
Fast track protocol
Gastrointestinal surgery
Hematology, Oncology and Palliative Medicine
HIPEC
Hospitals
Humans
Hyperthermia, Induced - methods
Morbidity
Mortality
Multivariate analysis
Ovarian cancer
Patients
Peritoneal Neoplasms - therapy
Peritoneal surface malignancies
Surgery
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Summary:Abstract Background The aim of this study was to analyze the results short term perioperative of patients with peritoneal surface malignancies undergoing cytoreduction with peritonectomy and HIPEC under a controlled fast track protocol and evaluate the factors related to the failure of implementation of the protocol. Patients and method We prospectively analyzed a consecutive series of patients (N = 156) with peritoneal surface malignancies treated by cytoreductive surgery with peritonectomy procedures and HIPEC from September 2008 until December 2014, in whom a fast track protocol was implemented. We limited the protocol to patients who had optimal cytoreduction, HIPEC administration, and not more than one digestive anastomosis. All patients signed informed consent for surgery and the perioperative multimodal recovery program. Results A total of 156 consecutive patients, with a median age of 57 years were included in the study. Median PCI was 8 (IQR: 0–32). Morbidity rate (Clavien-Dindo) was 25.6%, with a major morbidity rate (Clavien-Dindo III-IV) of 11.5%. One hundred and three patients (66%) completed the protocol. Multivariate analysis identified the following independent factors, which were related to failure of the protocol: age over 57 years (OR = 3.159, 95% CI: 1.286–7.758, p 
ISSN:0960-7404
1879-3320
DOI:10.1016/j.suronc.2016.08.001