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Cytoreductive Surgery With HIPEC Safe for Most Older Patients With Peritoneal Carcinomatosis: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 6, 2010 -- The majority of older patients with peritoneal carcinomatosis who undergo cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CS/HIPEC) recover without complications and are able to resume their normal routines, researchers said here today at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). Heather Thieme, MD, Mercy Medical Center, Baltimore, Maryland, and colleagues reviewed outcomes data in 29 patients aged over 65 years who underwent CS/HIPEC over a recent 10-year period. The number of older patients undergoing this surgery represents 15% of the total number of patients treated by this approach at Mercy Medical Center during the study time frame. “Previous studies have shown that cytoreductive surgery with HIPEC is an effective treatment for peritoneal carcinomatosis,” Dr. Thieme pointed out. “However, these are extensive surgeries that last several hours and include resection of organs as needed to remove tumour followed by a 90-minute infusion of heated chemotherapy into the abdominal cavity.” For this reason, patients need to be in reasonable health to successfully undergo the procedure, she said. In other types of surgery, it has been shown that elderly patients have more morbidity and mortality postoperatively than younger patients. General risk factors for surgery in elderly patients include frailty, chronic undernutrition, decreased muscle mass, and increased comorbidities such as heart disease, diabetes, pulmonary compromise, and limited functional status. Results showed that 19 of 29 patients in this series, or 66%, remained alive an average follow-up of 39 months. Also, 26 of the 29 patients did not need referral to a care facility upon discharge. Of patients who died of their disease, the average length of survival postoperatively was over 1 year. Two patients died within 30 days of their surgery. In both cases, the cause of death was myocardial infarction. One of the 2 patients had already been discharged from the hospital. The authors concluded that while the morbidity and mortality of CS/HIPEC surgery is a major concern in older patients, most patients could return to a functional quality of life postoperatively. [Presentation Title: Peritoneal Carcinomatosis in the Geriatric Patient: Outcomes With Cytoreductive Surgery and HIPEC. Abstract Number P290] E-mail this page to a friend or colleague! To print, use this version