Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, an update from the international PSOGI Registry.
Duran-Martínez, M Bergillos-Giménez, M Rodríguez-Ortíz, L Arjona-Sánchez, A
Duran-Martínez, M
Bergillos-Giménez, M
Rodríguez-Ortíz, L
Arjona-Sánchez, A
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2024-09-10
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Abstract
Introduction: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are established treatments for peritoneal surface malignancies, traditionally performed via laparotomy. Recent advancements in laparoscopic approaches (L-CRS + HIPEC) have shown promising results in selected patients.
Methods: The PSOGI registry, established in November 2019, collects data from specialized centers performing L-CRS + HIPEC. Data were collected prospectively and analyzed retrospectively, excluding risk-reducing procedures without peritoneal disease. The learning curve was assessed using a 14-cases cutoff.
Results: Today, 323 patients have been registered, 193 were included finally. Perioperative outcomes improved after 14 cases: Length of hospital stay was 7.78 ± 3.64 days (consolidation) versus 8.8 ± 8.79 days (learning) and major morbidity was 0% (consolidation) versus 5% (learning), (p = n.s.). Estimated blood loss was lower in the consolidation phase. Oncological outcomes also improved: Recurrence rate was 8.7% (consolidation) versus 17.8% (learning). Disease-free survival 5 years, 65% (learning) versus 88% (consolidation) (p = 0.012).
Conclusion: The L-CRS + HIPEC is a safe procedure with non-inferior oncologic outcomes which it is evaluating in an IDEAL setting by an international group. The validation of the learning curve, gives us the knowledge that a mentoring program must be setup to reduce the learning curve impact in oncologic failure.
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Duran-Martínez M, Bergillos-Giménez M, Rodríguez-Ortíz L, Arjona-Sánchez A; Laparoscopic PSOGI Registry. Laparoscopic Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy, an Update From the International PSOGI Registry. J Surg Oncol. 2024 Sep 10. doi: 10.1002/jso.27881. Epub ahead of print
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