Role of Enhanced Recovery Program for Colorectal Cancer Patients: National Cancer Institute Experience

Enhanced recovery program (ERP) was introduced in patients scheduled for colorectal surgical procedures to enhance gastrointestinal recovery and shorten their hospital stay. This study aims to evaluate the role of ERP in colorectal cancer patients. A prospective cohort study performed at National Cancer Institute-Cairo University including 50 patients with colorectal cancer treated between October 2016 and May 2017. They were divided in 2 equal groups: study group (ERP group) and control group (conventional protocol group). Incidence of postoperative morbidity was greater in the control group compared to the study group. Only the incidence of paralytic ileus was greater in the study group. The study group had a statistically significant hospital stay length compared to the control group. ERP was associated with lower incidence of postoperative morbidity excluding incidence of paralytic ileus; also, it was associated with a shorter hospital stay.

Hyperthermic Intraperitoneal Chemotherapy as a Treatment for Epithelial Ovarian Cancer

Treatment by cytoreductive surgery (CRS) and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) has been an option for selected patients with peritoneal carcinomatosis. This study aims to evaluate the impact of HIPEC in epithelial ovarian cancer (EOC). A retrospective observational cohort study including 48 EOC patients treated and followed up between 2012 and 2016. Thirty-seven cases were treated by CRS only, while 11 cases were treated by CRS and HIPEC. The study was performed at National Cancer Institute (NCI)-Cairo University. There was no statistically significant difference regarding overall survival or disease-free survival between the group of EOC patients treated by CRS only and the one treated by CRS and HIPEC. Presence of ascites and histological types (serous/non-serous) were the significant independent variables related to overall survival. Presence of ascites was the only independent variable associated with a significant relation to disease-free survival. No statistically significant impact of HIPEC in treatment of EOC was found in this study.

Methods of Treatment and Outcome for Ovarian Germ Cell Tumors

Ovarian germ cell tumors account for about 15-20% of all ovarian tumors. They occur mainly in girls, adolescents, and young adults. This study aims to assess the different clinico-pathological factors of ovarian germ cell tumors, treatment methods, and outcome. This is a retrospective observational cohort study including 54 cases with OGCTs which were studied from the period between January 2013 and December 2016. The study was performed at National Cancer Institute (NCI)-Cairo University, Egypt. All cases had cytoreductive surgery in the form of unilateral salpingo-oophorectomy in 42 cases and total abdominal hysterectomy in 12 cases. Complete cytoreduction was achieved in 46 cases while 8 cases had residual disease after surgery. Adjuvant chemotherapy was given in 26 cases (stage II, III, and IV malignant OGCTs). The main treatment of ovarian germ cell tumors is complete cytoreductive surgery which can be achieved in many cases with unilateral salpingo-oophorectomy. Adjuvant chemotherapy is highly recommended in case of malignant ovarian germ cell tumors.

Combined cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as a treatment for recurrent epithelial ovarian cancer-National Cancer Institute experience

BACKGROUND

Complete cytoreduction has been associated with survival benefit in the treatment of recurrent epithelial ovarian cancer (EOC). In this study, the aim is to investigate the role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of recurrent EOC.

PATIENTS AND METHODS

This is a descriptive (case series) study including 9 patients with recurrent EOC treated by CRS and HIPEC. They were treated and followed up between December 2011 and December 2017. The study was performed at The National Cancer Institute (NCI) - Cairo University (CU).

RESULTS

Postoperative death occurred in 2 cases, while recurrence occurred in one case. Six cases had smooth postoperative course and free follow-up. Median follow-up period was 39 months, ranging from 29 to 47 months. Median overall survival was 42 months while median disease-free survival was not reached.

CONCLUSIONS

Treatment of recurrent EOC by CRS and HIPEC appears to be promising. However, this line of treatment requires further evaluations and larger studies for better assessment of the potential survival benefits and possible complications.