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01-02-2015 | Original Scientific Report

Implementation of a Standardized HIPEC Protocol Improves Outcome for Peritoneal Malignancy

Authors: Anke M. J. Kuijpers, Arend G. J. Aalbers, Simon W. Nienhuijs, Ignace H. J. T. de Hingh, Marinus J. Wiezer, Bert van Ramshorst, Robert J. van Ginkel, Klaas Havenga, Wilma D. Heemsbergen, Michael Hauptmann, Victor J. Verwaal

Published in: World Journal of Surgery | Issue 2/2015

Abstract

Background

Experience with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in a pioneer hospital resulted in a treatment protocol that has become the standard in the Netherlands. Outcome of CRS and HIPEC was reviewed to assure differences between the pioneer phase and the period wherein the Dutch HIPEC protocol was clinically implemented.

Methods

The first consecutive 100 CRS and HIPEC procedures performed in the Netherlands were included as pioneer cohort (1995–1999). Two-hundred and seventy-two procedures that were performed in three participating HIPEC centres after the implementation of the Dutch HIPEC protocol were included as the implementation cohort (2005–2012). Another 100 recent patients of the first centre were included as a control group (2009–2011). Indications for the CRS and HIPEC treatment were peritoneal carcinomatosis (PC) from colorectal carcinoma and pseudomyxoma peritonei (PMP).

Results

Of the 472 included procedures, 327 (69 %) procedures were performed for PC from colorectal carcinoma and 145 for PMP (31 %). Compared with the implementation phase, the pioneer phase was characterized by more affected abdominal regions (mean 4.3 vs. 3.5, p < 0.001), more resections (mean 3.8 vs. 3.4, p < 0.001), less macroscopic radical cytoreductions (66 vs. 86 %, p < 0.001) and more patients with major morbidity (grade III–V) (64 vs. 32 %, p < 0.001). Other determinants of morbidity were high tumour load and multiple organ resections. Outcome of the implementation phase was similar to the control group.

Conclusions

This study determined that outcome had improved ever since the Dutch HIPEC protocol has been implemented based on completeness of cytoreduction and decreasing morbidity.

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Title: Implementation of a Standardized HIPEC Protocol Improves Outcome for Peritoneal Malignancy
Authors: Anke M. J. Kuijpers
Arend G. J. Aalbers
Simon W. Nienhuijs
Ignace H. J. T. de Hingh
Marinus J. Wiezer
Bert van Ramshorst
Robert J. van Ginkel
Klaas Havenga
Wilma D. Heemsbergen
Michael Hauptmann
Victor J. Verwaal
Publication date: 01-02-2015
Publisher: Springer US
Published in: World Journal of Surgery / Issue 2/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2801-y

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Springer Medicine

Implementation of a Standardized HIPEC Protocol Improves Outcome for Peritoneal Malignancy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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