Mosese is a non-training Registrar at Waikato Hospital.
Long-term Outcomes Following Cytoreductive Surgery And
Heated Intraperitoneal Chemotherapy At Waikato
Aim Cytoreductive surgery with heated intraperitoneal chemotherapy (CRS with IPC) for pseudomyxoma peritonei was first introduced to Waikato in 2008. Waikato and Braemar Hospitals are currently the only centres within New Zealand performing the procedure. Recently, we published short term outcome data, this study is a continuation of said study and assesses survival and recurrence data for our cohort of patients.
Method Patient data was collected retrospectively for the first 100 CRS with IPC operations with curative intent at Waikato and Braemar Hospitals from 2008 to 2017. Data encompasses all parts of the patient surgical pathway; pre-operative characteristics and work up, intraoperative and post-operative outcomes. All surgeries were completed utilising the Sugarbaker technique.
Results 100 CRS with IPC operations were completed for 90patients. Our cohort was female predominant (65%), with a mean age of 29, mean BMI of 29 and a median American Society of Anaesthesiology score of 2. Ten operations were repeat operations for recurrent disease.
74 patients had pseudomyxoma peritonei, 12 colorectal carcinoma and 14 with other cancer types pre-operatively. The median prior surgical score was 1, with 29% of patients having 2 or more previous abdominal surgeries. Our mean operating time was 500 minutes. The median length of admission was 11 days. Our major complication rate (Clavien-Dindo grades IIIa-IVb) was 28%. 11% were found to have recurrence, with a median time to recurrence of 405 days. The 1 year mortality was 5% and median follow up time of 2 years.
Conclusion Outcomes for CRS with IPC at Waikato are comparable to international literature. Our operation numbers are similar in volume to Australia, and, comparable in mixture of cancer types indicated for surgery internationally. Peritoneal surface malignancy is a growing specialty with expanding indications, our cohort reflects potential use of CRS in other cancers types.