Peritonectomía radical y quimioterapia intraperitoneal : cinco años de experiencia en la Fundación Santa Fe de Bogotá (ONCOLGroup - estudio ATIA).

Peritoneal cytoreductive surgery and intraperitoneal chemotherapy : five years of experience at the Fundación Santa Fe de Bogotá (ONCOLGroup - ATIA study).

Publicado 2013-03-01

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Vol. 2 Núm. 1 (2013): Marzo
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Peritonectomía radical y quimioterapia intraperitoneal : cinco años de experiencia en la Fundación Santa Fe de Bogotá (ONCOLGroup - estudio ATIA).
Rev. colomb. hematol. oncol. [Internet]. 2013 Mar. 1 [cited 2024 Dec. 22];2(1):22-33. Disponible en: https://doi.org/10.51643/22562915.328
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Jorge Miguel Otero
Fundación Santa Fe de Bogotá
    Fernando Arias
    Fundación Santa Fe de Bogotá
      Eduardo Londoño
      Fundación Santa Fe de Bogotá
        Martha Mora
        Fundación Santa Fe de Bogotá
          Henry Becerra
          Fundación Santa Fe de Bogotá
            Mostrar biografía de los autores

            Jorge Miguel Otero,

            Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Fernando Arias,

            Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Eduardo Londoño,

            Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Martha Mora,

            Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Henry Becerra,

            Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogotá (Bogotá, Colombia)

            Natalia Cortés,

            Departamento de Cirugía, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Ómar Salamanca,

            Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Departamento de Medicina Interna, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Carlos Guerrero,

            Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Departamento de Anestesiología, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Hernán Carranza,

            Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer – FICMAC (Bogotá, Colombia).

            Carlos Vargas,

            Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer – FICMAC (Bogotá, Colombia).

            Laura Bernal,

            Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogotá (Bogotá, Colombia)

            Andrés Felipe Cardona,

            Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Sección Enfermedades del Peritoneo, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Objetivo: Evaluar varios desenlaces tempranos en una cohorte de pacientes con neoplasias del peritoneo tratados con peritonectomía radical seguida de quimioterapia hipertérmica intraperitoneal (hyperthermic intraperitoneal chemotherapy, HIPEC). Métodos: Se incluyeron 48 pacientes tratados consecutivamente con peritonectomía radical más HIPEC, entre noviembre de 2007 y junio de 2012; 34 pacientes (70,8%) presentaron tumores de origen apendicular, 6 (12,5%) fueron primarios del peritoneo, 3 (6,3%) de ovario, 3 (6,3%) de colon, 1 carcinosarcoma (2,1%) y 1 (2,1%) angiosarcoma. La edad promedio fue 51 años (±13,1) y la mediana de seguimiento 30 meses (r, 1-46). Se valoraron diversos datos demográficos, la histología, el índice de carcinomatosis peritoneal (PCI), las características de los procedimientos quirúrgicos y varios desenlaces, como la supervivencia libre de recaída (SLR) y la global (SG). También, se determinó la morbilidad y mortalidad a corto plazo. Resultados: En 34 pacientes se logró realizar citorreducción completa (71%). El PCI promedio fue 18 (<_x0031_0: _x0032_7_x002c_2_x0025_ y>10: 70,8%) y la mediana para el tiempo quirúrgico, la estancia en UCI, la duración del soporte nutricional y el tiempo de estancia hospitalaria fueron 14,1 horas (±3,2), 9,3 días (±7), 12,8 días (±9,6) y 29,5 días (±18,6), respectivamente. Las complicaciones más frecuentes fueron eventos tromboembólicos (31%), bacteremia relacionada con catéter (23%), las fístulas (17%), la nefrotoxicidad (17%) y la fuga biliar (8,3%). Dos pacientes (4,2%) fallecieron por complicaciones asociadas al procedimiento. Dieciséis pacientes (33%) tuvieron recaída con una mediana de SLR de 20 meses (IC95%, 11,3-28,4). Conclusiones: La cirugía citorreductiva más HIPEC en pacientes bien seleccionados que presentan neoplasias que afectan el peritoneo es un procedimiento que se puede realizar en Colombia con un adecuado perfil de seguridad y eficacia. La mortalidad fue similar a lo reportado en la literatura mundial.

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