P-0261 - The management of peritoneal surface malignancies at the American University of Beirut Medical Center: initial experience

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Gastrointestinal Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Faek Jamali
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors F. Jamali1, M. Seoud2, M. Khalifeh2
  • 1Ameican University of Beirut Medical Center, Beirut/LB
  • 2American University of Beirut Medical Center, Beirut/LB

Abstract

Introduction

Peritoneal carcinomatosis (PC) has been traditionally considered a terminal disease with median survivals reported in the literature of 6 to 12 months. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have gradually gained acceptance as the standard of care in the management of selected cases of PC. Excellent results have been achieved in well-selected patients but there is a very steep learning curve when starting a new program.

Methods

A program for the multidisciplinary treatment of peritoneal surface malignancies of gastrointestinal or gynecological origin was initiated in January 2010 at the American University of Beirut Medical Center. Patients enrolled in the program were treated using multimodality therapy with combinations of systemic therapy, cytoreductive surgery (CRS), and HIPEC. We present the results of our initial experience using a retrospective review of a prospectively collected database.

Results

23 patients were treated with CRS and HIPEC. There were 10 male and 13 female patients. Most common indication (35%) was PC of colorectal origin, followed closely by pseudomyxoma (30%), ovarian malignancies (22%), gastric cancer (8%) and mesothelioma (4%). The Mean duration of surgery was 480 minutes. Mean Peritoneal Cancer Index was 26. Twenty-one (91%) patients had a complete cytoreduction. Major morbidity and mortality rates were 35 and 4.3 per cent, respectively. Mean hospital stay was 16 days. At a mean follow-up of 18 months, median survival has not been reached.

Conclusion

We report the successful establishment of an active peritoneal surface malignancy multidisciplinary treatment program with excellent early results that are comparable to those published by reputable centers in the literature. Careful patient selection, a multidisciplinary approach and proper surgical training and technique are essential for the success of such a program.