Evolving strategies for surgical management of carcinomatosis.

摘要

I read with great interest the manuscript presented by Hadi and colleagues regarding their experience with cytoreductive surgery and perioperative intraperitoneal chemotherapy for the management of patients who have a peritoneal surface malignancy. The manuscript focuses on an evolution of treatment strategies used over an 8-year time period. Both the results of treatment and morbidity and mortality data were presented. The authors present interesting findings that suggest that over time both the use of transfused blood and the length of hospital stay decreased. Undoubtedly, the learning curve effect has caused this change. Some of the information that is presented in the figures is predictable and is supported by other publications. For example, complete cytoreduction has always been associated with improved survival, and indeed, it is usually the dominant variable in a multi-variant analysis of this type of data. Also, the separation of patients by groups regarding clinical features is expected to beassociated with improved survival.