Pediatric ovarian angiosarcoma treated with systemic chemotherapy and cytoreductive surgery with heated intraperitoneal chemotherapy: Case report and review of therapy

2019 ◽  
Vol 66 (7) ◽  
pp. e27753 ◽  
Author(s):  
Holly Pariury ◽  
Carla Golden ◽  
Winston W. Huh ◽  
Elaine Cham ◽  
Taylor Chung ◽  
...  
Keyword(s):  
Case Report ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Systemic Chemotherapy ◽  
Heated Intraperitoneal Chemotherapy

scholarly journals Neutropenia and thrombocytopenia after cytoreductive surgery and heated intraperitoneal chemotherapy

2017 ◽  
Vol 2 (3) ◽  
pp. 137-141 ◽  
Author(s):  
Ben Finlay ◽  
Timothy Price ◽  
Peter Hewett
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Systemic Chemotherapy ◽  
Haematological Toxicity ◽  
Subsequent Growth ◽  
Single Centre ◽  
Post Procedure ◽  
Heated Intraperitoneal Chemotherapy ◽  
Crs And Hipec ◽  
Grade 3

AbstractBackgroundNeutropenia and thrombocytopenia are well-recognised complications of systemic chemotherapy. In cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC), the interplay between surgical factors and systemic toxicity of chemotherapeutics must be considered when considering post-operative haematological outcomes. We sought to quantify the incidence of these events in cytoreductive surgery and HIPEC at our institution.MethodsWe conducted a single centre, a retrospective cohort study of 50 consecutive patients who underwent cytoreductive surgery and HIPEC from 2002 to 2015. Routine haematological data were analysed and complications classified according to CTCAE 4.0. Subgroup analysis was undertaken to compare those who received or not perioperative systemic chemotherapy.ResultsThe rate of all-grade post-procedure neutropenia was 4 % (n=2/50); one grade 1, and one grade 4 neutropenia. The patient with grade 4 neutropenia died day 57 post-operatively, despite subsequent growth factor support. Eight percent (n=4/50) of patients had thrombocytopenia preoperatively. The overall rate of post-procedure thrombocytopenia was 46 % with grade 3–4 thrombocytopenia of 4 %. If not present preoperatively, thrombocytopenia onset was on day 1 or 2 post-operatively, with a median duration of 3 days.ConclusionsIntraperitoneal delivery of chemotherapy as HIPEC can cause haematological toxicity with potentially fatal outcomes. However, the incidence of neutropenia and thrombocytopenia after CRS and HIPEC is low.

Factors Predictive of Outcomes after Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Colon and Appendiceal Carcinomatosis: A Single-Institution Experience

2018 ◽  
Vol 84 (10) ◽  
pp. 1575-1579
Author(s):  
Blake Babcock ◽  
Brice Jabo ◽  
Matthew Selleck ◽  
Mark Reeves ◽  
Carlos Garberoglio ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Lymph Node Status ◽  
Long Term Outcomes ◽  
Node Status ◽  
Heated Intraperitoneal Chemotherapy ◽  
Short And Long Term

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC), although considered an acceptable treatment option in the management of selected patients with colon and appendiceal peritoneal carcinomatosis (PC), concerns about morbidity have limited its acceptance. Our objective was to evaluate the short- and long-term outcomes of CRS/HIPEC for appendix and colon PC performed at our institution and to elucidate factors predictive of patient outcomes. All patients who underwent CRS/HIPEC for appendix or colon PC from 2011 to 2017 were identified from our institution's prospective database. Postoperative outcomes, overall survival, and recurrence-free survival were assessed. Of 125 patients who underwent CRS/HIPEC during the study period, 45 patients were eligible (appendix n = 26; colon n = 19). The median postoperative length of stay was nine days (5–28 days). Grade III/IV complications occurred in 4/45 (8.8%) patients. There were no postoperative mortalities. Median DFS and overall survival have not yet been reached, in both the colon and appendix groups. As of the study conclusion date, 37/45 (82.2%) patients were alive with or without disease. Lymph node status was predictive of recurrence in appendix PC. In our experience, CRS/HIPEC can be safely performed with acceptable short- and long-term outcomes. Lymph node status is an important predictor of recurrence.

scholarly journals Postoperative paralytic ileus after cytoreductive surgery combined with heated intraperitoneal chemotherapy

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Jesper Nors ◽  
Jonas Amstrup Funder ◽  
David Richard Swain ◽  
Victor Jilbert Verwaal ◽  
Tom Cecil ◽  
...  
Keyword(s):  
Median Time ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Paralytic Ileus ◽  
University Hospital ◽  
Nasojejunal Tube ◽  
Heated Intraperitoneal Chemotherapy ◽  
Duration Of Surgery ◽  
Crs And Hipec ◽  
Peritoneal Malignancy

AbstractBackgroundPatients with peritoneal malignancy treated by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) are prone to develop postoperative paralytic ileus (POI). POI is associated with significant increase in both morbidity and mortality. CRS and HIPEC commonly result in prolonged POI (PPOI). The objective was to clarify the extent of PPOI in patients treated by CRS and HIPEC for peritoneal malignancy.MethodsThis was a prospective multicenter study including patients operated with CRS and HIPEC at the Department of Surgery, Aarhus University Hospital, Denmark and the Peritoneal Malignancy Institute, Basingstoke, United Kingdom. A total of 85 patients were included over 5 months. Patients prospectively reported parameters of postoperative gastrointestinal function in a diary from post-operative day 1 (POD1) until discharge. PPOI was defined as first defecation on POD6 or later.ResultsMedian time to first flatus passage was 4 days (range 1–12). Median time to first defecation was 6 days (1–14). Median time to removal of nasojejunal tube was 4 days (3–13) and 7 days (1–43) for nasogastric tube. Forty-six patients (54%) developed PPOI. Patients with PPOI had longer time to first flatus (p<0.0001) and longer time to removal of nasojejunal tube (p=0.001). Duration of surgery correlated to time to first flatus (p=0.015) and time to removal of nasogastric or nasojejunal tube (p<0.0001) but not to time to first defecation (p=0.321).ConclusionsPostoperative gastrointestinal paralysis remains a common and serious problem in patients treated with CRS and HIPEC.

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