Affiliation:
1. Unit of Surgical Oncology Reina Sofia University Hospital Cordoba Spain
2. Department of Biochemistry and Molecular Biology, GE09 Research in Peritoneal and Retroperitoneal Oncologic Surgery Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital University of Cordoba Córdoba Spain
Abstract
ABSTRACTIntroductionCytoreductive 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.MethodsThe 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.ResultsToday, 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).ConclusionThe 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.