Impact of learning curve on outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer patients at a specialized center.

BACKGROUND

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are promising treatments for colorectal cancer-related peritoneal metastases. The learning curve may influence surgical outcomes.

OBJECTIVE

The aim of the study was to compare outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy during the learning curve versus after surgical proficiency at a gastrointestinal cancer center.

METHODS

A retrospective study of 83 patients treated between 2018 and 2023. Group 1 (n=42) included initial cases; Group 2 (n=41) represented the experienced phase. Operation time, organ resections, morbidity, transfusion needs, and survival were compared.

RESULTS

Severe morbidity (Clavien-Dindo grade 3-4) was similar in both groups (G1: 21.4%, G2: 29.2%; p=0.947). No 30- or 90-day mortality occurred. Transfusions of ≥3 units were more frequent in G1 (p=0.003). Mean operative time was longer in G1 (8.5 vs. 7.2 h). More patients in G2 had multiple organ resections (p<0.001).

CONCLUSION

The learning curve significantly influences perioperative outcomes in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedures. As surgical experience increases, intraoperative transfusion requirements and operative time decrease, while the extent of resection improves. However, these improvements do not appear to translate into a survival benefit.