Yedikule Surp Pırgiç Ermeni Hastanesi

Abstract Background: Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) with a closed CO2 recirculation has been recently developed to amplify better distribution of chemotherapeutic drugs and adequate fluid circulation due to turbulent flow and increased intraabdominal pressure by CO2. In this study, we aimed to present clinicopathological features of patients with peritoneal carcinomatosis who underwent HIPEC with closed CO2 recirculation and the technical features of the technique. Methods: Twenty patients who underwent cytoreductive surgery for peritoneal carcinomatosis followed by the closed CO2 recirculation HIPEC between November 2018 and October 2019 were retrospectively analyzed. Demographic and clinical variables and treatment outcomes were recorded. Results: There were 11 (55%) female and nine (45%) male patients with a mean age of 57.6 ± 10.3 years. Colon and ovarian cancer was the primary diagnosis in 10 (50%) and 4 patients (20%), respectively. The median peritoneal carcinomatosis index score was 15 (2-35). Colectomy and peritonectomy were the most common operations. During the early postoperative period, rate of minor and major complications were seen in six (30%) and three patients (15%), respectively. Median length of hospital stay and follow-up period were 6 days (4–15 days) and 7.5 months (2–17 months), respectively. There were three nonsurgical complications (pulmonary embolism, renal failure, myocardial infarction) leading to mortality in three patients (15%) during the follow-up period. Conclusions: HIPEC with CO2 recirculation may be a safe and feasible approach that can be performed in patients with peritoneal carcinomatosis secondary to different types of cancer.

The aim of this retrospective clinical study was to evaluate the accuracy and feasibility of two different clinical scales, namely the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and Tenon's axillary scoring system, which were developed for predicting the non-sentinel lymph node (NSLN) status in our breast cancer patients. The medical records of patients who were diagnosed with breast cancer between January 2010 and November 2013 were reviewed. Those who underwent sentinel lymph node biopsy (SLNB) for axillary staging were recruited for the study, and patients who were found to have positive SLNB and thus were subsequently subjected to axillary lymph node dissection (ALND) were also included. Patients who had neoadjuvant therapy, who had clinically positive axilla, and who had stage 4 disease were excluded. Patients were divided into two groups. Group 1 included those who had negative NSLNs, whereas Group 2 included those who had positive NSLNs. The following data were collected: age, tumor size, histopathological characteristics of the tumor, presence of lymphovascular invasion, presence of multifocality, number of negative and positive NSLNs, size of metastases, histopathological method used to define metastases, and receptor status of the tumor. The score of each patient was calculated according to the MSKCC nomogram and Tenon's axillary scoring system. Statistical analysis was conducted to investigate the correlation between the scores and the involvement of NSLNs. The medical records of patients who were diagnosed with breast cancer and found to have SLNB for axillary staging was reviewed. Finally, 50 patients who had positive SLNB and thus were subsequently subjected to ALND were included in the study. There were 17 and 33 patients in Groups 1 and 2, respectively. Both the MSKCC nomogram and Tenon's axillary scoring system were demonstrated to be significantly accurate in the prediction of the involvement of NSLNs (p<0.05 for each). Among all the parameters, the only one that was found to be correlated with the risk of NSLN involvement was the presence of lymphovascular invasion. The MSKCC nomogram and Tenon's axillary scoring system both seem to be reliable tools for the assessment of NSLN status in SLNB-positive breast cancer in our breast cancer population. Nevertheless, the omission of ALNB in SLNB-positive breast cancer cannot be yet recommended because of the lack of long-term results of current nomograms and scoring systems.