ABSTRACT
BACKGROUND: The combined treatment of peritoneal carcinomatosis with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a rigorous surgical treatment, most suitable for young and good performance status patients. We evaluated the outcomes of elderly patients undergoing CRS and HIPEC for peritoneal carcinomatosis with careful perioperative care. METHODS: All consecutive patients 70 years of age or older who were treated for peritoneal carcinomatosis over the past five years were included. Primary outcomes were perioperative morbidity and mortality. Secondary outcomes were disease-free survival and overall survival. RESULTS: From a pool of 100 patients, with a diagnosis of PC who underwent CRS and HIPEC in our center, we have included 30 patients at an age of 70 years or older and the results were compared to the patients younger than 70 years. The total morbidity rate was 50% versus 41.5% in the group younger than 70 years (NSS).The mortality rate was 3.3% in the elderly group versus 1.43%in the younger group (NSS). Median overall survival was 30 months in the older group versus 38 months in the younger group. CONCLUSION: Cytoreductive surgery and HIPEC for peritoneal carcinomatosis may be safely performed with acceptable morbidity in selected elderly patients.
Subject(s)
Carcinoma/surgery , Peritoneal Neoplasms/surgery , Aged , Aged, 80 and over , Carcinoma/drug therapy , Carcinoma/mortality , Chemotherapy, Cancer, Regional Perfusion/methods , Chemotherapy, Cancer, Regional Perfusion/mortality , Female , Humans , Hyperthermia, Induced/methods , Hyperthermia, Induced/mortality , Male , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/mortality , Prospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
PURPOSE: Lung cancer is the most common cause of cancer death in both men and women in our country. It has been estimated that there will be 6,000 lung cancer deaths every year in Greece. However, many patients with bronchogenic carcinoma also have coexistent obstructive lung disease. In these patients, preoperative prediction of functional status after lung resection is mandatory. The aim of our study was to determine the effect of lung resection on postoperative spirometric lung function. PATIENTS AND METHODS: 112 patients underwent spirometric pulmonary tests preoperatively, and at 3 and 6 months after their operation. The predicted postoperative forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were calculated using the formula of Juhl and Frost: predicted postoperative FEV1 (or FVC)=preoperative FEV1(or FVC) x[1-(S x 0.0526)], where S=number of segments resected. Statistical significance was defined as a p value < 0.05. RESULTS: The functional percentage losses at 6 months for lobectomies and pneumonectomies were 7.34% and 34.89% for FVC and 7.72%; and 32.53% for FEV, respectively. The linear regression analysis derived from the correlation between predicted and measured FEV1 resulted in 2 equations for lobectomy and pneumonectomy. The first, for lobectomy, was: FEV1POSTOP=0.00211 + 0.896660 x FEV1PREOP; and the second, for pneumonectomy, was: FEV1POSTOP=0.145 + 0.65318 x FEV1PREOP. CONCLUSION: We conclude that our formulas are a reliable method for predicting postoperative respiratory function of the patients with lung cancer.
