Resumen de Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei and appendix tumours in elderly patients: Is it justified?
Víctor López López, Pedro Antonio Cascales Campos, Elena Gil, Julio Arévalo Pérez, A. Gonzalez, José Gil Martínez, F.C. Muñoz Casares, Juan Torres Melero, Pedro Barrios Sánchez, Rafael Morales Soriano, I. Ramos, Gloria Ortega Pérez, Bruno Camps Vilata, Luis González Bayón, Pere Bretcha Boix, José Farré Alegre, Santiago González Moreno, Pascual Parrilla Paricio
Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei and appendix tumours are widespread in the world. It is unclear what should be the attitude in elderly patients.
Methods This retrospective multicenter study collected the database from ten Spanish centers from Spanish Group of Peritoneal Cancer Surgery. The study period was between November 2002 and March 2014. Seventeen patients with age greater than or equal to 75 years with peritoneal carcinomatosis from pseudomyxoma peritonei and appendix tumours met the selection criteria for the study. Outcomes in terms of morbidity and mortality such as disease-free and overall survival were analyzed.
Results Median PCI was 16 (range 6–39). Ten postoperative adverse events were detected in nine patients (44.4%). 28% were grade I–II and 17% were grade III–IV. Disease-free survival at 1 and 3 years was 67 and 44%, respectively. Overall survival at 1 and 3 years was 100 and 88%, respectively. Only cytoreduction was related to worst disease free survival after univariate (p = 0.007) and multivariate (OR 11.639, 95% CI 1.24–109.74, p = 0.03) analyses. Cytoreduction was related to the worst overall survival after univariate analysis (p = 0.046).
Conclusion Cytoreductive surgery and HIPEC for pseudomyxoma peritonei and appendix tumours in elderly patients it is a procedure with feasible postoperative morbi-mortality and survival outcomes.
