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Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series

BACKGROUND: Perforated or pT4 colonic tumors have a bad prognosis with a high rate of relapse, including peritoneal relapse (20–30%). Our aim is to analyze the effectiveness of Second Look surgery (SLS) + hyperthermic intraperitoneal chemotherapy (HIPEC) in these patients for early treatment of peri...

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Autores principales: Moral, Ángel Serrano del, Viejo, Estíbalitz Pérez, Romero, Israel Manzanedo, Pérez, Fernando Pereira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851413/
https://www.ncbi.nlm.nih.gov/pubmed/33552500
http://dx.doi.org/10.1016/j.amsu.2021.01.072
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author Moral, Ángel Serrano del
Viejo, Estíbalitz Pérez
Romero, Israel Manzanedo
Pérez, Fernando Pereira
author_facet Moral, Ángel Serrano del
Viejo, Estíbalitz Pérez
Romero, Israel Manzanedo
Pérez, Fernando Pereira
author_sort Moral, Ángel Serrano del
collection PubMed
description BACKGROUND: Perforated or pT4 colonic tumors have a bad prognosis with a high rate of relapse, including peritoneal relapse (20–30%). Our aim is to analyze the effectiveness of Second Look surgery (SLS) + hyperthermic intraperitoneal chemotherapy (HIPEC) in these patients for early treatment of peritoneal relapse (PR) or for preventing it. PATIENTS AND METHODS: Patients previously operated for colon cancer, either pT4 or perforated (M0), with no evidence of disease at any level after adjuvant chemotherapy, who undergo systematic SLS + HIPEC (Oxaliplatin 30 min) one year after the initial surgery. RESULTS: Since February 2014 to July 2018, we performed SLS + HIPEC in 42 patients with M0, either pT4 (n = 33) or perforated (n = 9) colon cancer. Although during SLS there were suspicious lesions in 15 cases (37.5%), they were histologically confirmed in only 4 (9.5%). Histologically confirmed peritoneal relapse (PR) rate at SLS was 6% in pT4 (2/33) and 22.2% in perforated tumors (2/9). Prophylactic HIPEC was performed in all the cases. There was no postoperative mortality. Grade III-IV morbidity occurred in 19% (8/42). With a median follow-up of 33.8 months after primary tumor surgery, 6/42 patients (14.3%) presented peritoneal relapse (PR). 3-year peritoneal disease free survival was 86%, with 3-year disease free survival of 78.6% and 5-year overall survival (OS) of 97.4%. CONCLUSION: Peritoneal relapse and survival rates are remarkable in these groups of, a priori, very bad prognosis, which could suggest a beneficial effect of HIPEC.
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spelling pubmed-78514132021-02-05 Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series Moral, Ángel Serrano del Viejo, Estíbalitz Pérez Romero, Israel Manzanedo Pérez, Fernando Pereira Ann Med Surg (Lond) Original Research BACKGROUND: Perforated or pT4 colonic tumors have a bad prognosis with a high rate of relapse, including peritoneal relapse (20–30%). Our aim is to analyze the effectiveness of Second Look surgery (SLS) + hyperthermic intraperitoneal chemotherapy (HIPEC) in these patients for early treatment of peritoneal relapse (PR) or for preventing it. PATIENTS AND METHODS: Patients previously operated for colon cancer, either pT4 or perforated (M0), with no evidence of disease at any level after adjuvant chemotherapy, who undergo systematic SLS + HIPEC (Oxaliplatin 30 min) one year after the initial surgery. RESULTS: Since February 2014 to July 2018, we performed SLS + HIPEC in 42 patients with M0, either pT4 (n = 33) or perforated (n = 9) colon cancer. Although during SLS there were suspicious lesions in 15 cases (37.5%), they were histologically confirmed in only 4 (9.5%). Histologically confirmed peritoneal relapse (PR) rate at SLS was 6% in pT4 (2/33) and 22.2% in perforated tumors (2/9). Prophylactic HIPEC was performed in all the cases. There was no postoperative mortality. Grade III-IV morbidity occurred in 19% (8/42). With a median follow-up of 33.8 months after primary tumor surgery, 6/42 patients (14.3%) presented peritoneal relapse (PR). 3-year peritoneal disease free survival was 86%, with 3-year disease free survival of 78.6% and 5-year overall survival (OS) of 97.4%. CONCLUSION: Peritoneal relapse and survival rates are remarkable in these groups of, a priori, very bad prognosis, which could suggest a beneficial effect of HIPEC. Elsevier 2021-01-24 /pmc/articles/PMC7851413/ /pubmed/33552500 http://dx.doi.org/10.1016/j.amsu.2021.01.072 Text en © 2021 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Moral, Ángel Serrano del
Viejo, Estíbalitz Pérez
Romero, Israel Manzanedo
Pérez, Fernando Pereira
Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series
title Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series
title_full Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series
title_fullStr Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series
title_full_unstemmed Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series
title_short Results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. Case series
title_sort results of systematic second-look surgery plus hipec in perforated or pt4 colon cancer. case series
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851413/
https://www.ncbi.nlm.nih.gov/pubmed/33552500
http://dx.doi.org/10.1016/j.amsu.2021.01.072
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