%0 Journal Article
%T Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis in the Elderly
%A J. D. Spiliotis
%A E. Halkia
%A V. A. Boumis
%A D. T. Vassiliadou
%A A. Pagoulatou
%A E. Efstathiou
%J International Journal of Surgical Oncology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/987475
%X Background. The combined treatment of peritoneal carcinomatosis with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a rigorous surgical treatment, most suitable for young and good performance status patients. We evaluated the outcomes of elderly patients undergoing CRS and HIPEC for peritoneal carcinomatosis with careful perioperative care. Methods. All consecutive patients 70 years of age or older who were treated for peritoneal carcinomatosis over the past five years were included. Primary outcomes were perioperative morbidity and mortality. Secondary outcomes were disease-free survival and overall survival. Results. From a pool of 100 patients, with a diagnosis of PC who underwent CRS and HIPEC in our center, we have included 30 patients at an age of 70 years or older and the results were compared to the patients younger than 70 years. The total morbidity rate was 50% versus 41.5% in the group younger than 70 years (NSS). The mortality rate was 3.3% in the elderly group versus 1.43% in the younger group (NSS). Median overall survival was 30 months in the older group versus 38 months in the younger group. Conclusion. Cytoreductive surgery and HIPEC for peritoneal carcinomatosis may be safely performed with acceptable morbidity in selected elderly patients. 1. Introduction Peritoneal carcinomatosis (PC) is associated with a poor prognosis, and, once it is diagnosed, survival is generally less than 6 months [1, 2]. Peritoneal carcinomatosis represents a devastating form of cancer progression and the pathogenesis of this clinical entity can be explained by several biological models and a better understanding of underlying tumor kinetics and cellular dissemination mechanisms [3]. A considerable number of patients presenting with peritoneal carcinomatosis from digestive or gynecological cancers are aged 70 or older. Offering a safe and appropriate treatment to elderly patients with PC presents a challenge for healthcare resources. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) plays an important therapeutic role in patients with PC [4]. On the other hand, elderly patients are traditionally associated more frequently with comorbidities and a reduced capacity to recover or tolerate aggressive surgery [5, 6]. Several recent results have shown that age alone does not influence the outcome of surgery and cancer-specific survival in these patients is similar to that of younger patients [7¨C9]. As for the management of PC nowadays, many patients are treated in specialized centers around
%U http://www.hindawi.com/journals/ijso/2014/987475/