Cytoreduction and hyperthermic intraperitoneal chemotherapy : The learning curve reassessed
(2016) In European Journal of Surgical Oncology 42(2). p.244-250- Abstract
Background CytoReductive Surgery and Hyperthermic IntraPEritoneal Chemotherapy (CRS-HIPEC) is now the preferred treatment of many peritoneal surface malignancies. In this retrospective study we aimed to analyze how several performance indicators changed during the first 100 CRS-HIPEC procedures in hospitals which recently introduced this treatment, and compare those with an experienced institution. Methods The first consecutive 100 CRS-HIPEC procedures of three institutions were compared to those of the pioneer hospital. The training provided by the pioneer hospital consisted of hands-on training during the first ten procedures; hereafter guidance was available on consult basis. Operation characteristics, morbidity and completeness of... (More)
Background CytoReductive Surgery and Hyperthermic IntraPEritoneal Chemotherapy (CRS-HIPEC) is now the preferred treatment of many peritoneal surface malignancies. In this retrospective study we aimed to analyze how several performance indicators changed during the first 100 CRS-HIPEC procedures in hospitals which recently introduced this treatment, and compare those with an experienced institution. Methods The first consecutive 100 CRS-HIPEC procedures of three institutions were compared to those of the pioneer hospital. The training provided by the pioneer hospital consisted of hands-on training during the first ten procedures; hereafter guidance was available on consult basis. Operation characteristics, morbidity and completeness of cytoreduction were evaluated by case sequence. Locally-estimated-scatter-plot smoothing was used to evaluate the learning curve. Results From four institutions 372 cases were included. A macroscopic complete cytoreduction was reached in 66% of the cases in the pioneer hospital and in 86% in the new hospitals (p < 0.001). Complete cytoreduction rates were higher at start off in the new institutions compared with the experienced institution and increased significantly in the first 100 procedures. The new hospitals started with lower morbidity than the experienced hospital, which did not significantly decrease during the study period. Conclusion New institutions that were trained and mentored by an experienced CRS-HIPEC hospital performed better from the beginning with regard to complete cytoreduction and morbidity rate with than the experienced center. An improvement in complete cytoreduction rate during the first 100 procedures was observed in the new institutions.
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- author
- Kuijpers, A. M. ; Hauptmann, M. ; Aalbers, A. G. ; Nienhuijs, S. W. ; De Hingh, I. H. ; Wiezer, M. J. ; Van Ramshorst, B. ; Van Ginkel, R. J. ; Havenga, K. and Verwaal, V. J. LU
- publishing date
- 2016-02-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- CytoReductive surgery, HIPEC, Learning curve, Peritoneal metastasis
- in
- European Journal of Surgical Oncology
- volume
- 42
- issue
- 2
- pages
- 244 - 250
- publisher
- Elsevier
- external identifiers
-
- pmid:26375923
- scopus:84955354756
- ISSN
- 0748-7983
- DOI
- 10.1016/j.ejso.2015.08.162
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2015 Elsevier Ltd.
- id
- 002052df-6e64-4dde-9f9c-9c6055eb3bd4
- date added to LUP
- 2022-04-12 11:01:11
- date last changed
- 2024-03-10 07:14:28
@article{002052df-6e64-4dde-9f9c-9c6055eb3bd4,
abstract = {{<p>Background CytoReductive Surgery and Hyperthermic IntraPEritoneal Chemotherapy (CRS-HIPEC) is now the preferred treatment of many peritoneal surface malignancies. In this retrospective study we aimed to analyze how several performance indicators changed during the first 100 CRS-HIPEC procedures in hospitals which recently introduced this treatment, and compare those with an experienced institution. Methods The first consecutive 100 CRS-HIPEC procedures of three institutions were compared to those of the pioneer hospital. The training provided by the pioneer hospital consisted of hands-on training during the first ten procedures; hereafter guidance was available on consult basis. Operation characteristics, morbidity and completeness of cytoreduction were evaluated by case sequence. Locally-estimated-scatter-plot smoothing was used to evaluate the learning curve. Results From four institutions 372 cases were included. A macroscopic complete cytoreduction was reached in 66% of the cases in the pioneer hospital and in 86% in the new hospitals (p < 0.001). Complete cytoreduction rates were higher at start off in the new institutions compared with the experienced institution and increased significantly in the first 100 procedures. The new hospitals started with lower morbidity than the experienced hospital, which did not significantly decrease during the study period. Conclusion New institutions that were trained and mentored by an experienced CRS-HIPEC hospital performed better from the beginning with regard to complete cytoreduction and morbidity rate with than the experienced center. An improvement in complete cytoreduction rate during the first 100 procedures was observed in the new institutions.</p>}},
author = {{Kuijpers, A. M. and Hauptmann, M. and Aalbers, A. G. and Nienhuijs, S. W. and De Hingh, I. H. and Wiezer, M. J. and Van Ramshorst, B. and Van Ginkel, R. J. and Havenga, K. and Verwaal, V. J.}},
issn = {{0748-7983}},
keywords = {{CytoReductive surgery; HIPEC; Learning curve; Peritoneal metastasis}},
language = {{eng}},
month = {{02}},
number = {{2}},
pages = {{244--250}},
publisher = {{Elsevier}},
series = {{European Journal of Surgical Oncology}},
title = {{Cytoreduction and hyperthermic intraperitoneal chemotherapy : The learning curve reassessed}},
url = {{http://dx.doi.org/10.1016/j.ejso.2015.08.162}},
doi = {{10.1016/j.ejso.2015.08.162}},
volume = {{42}},
year = {{2016}},
}