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- W4312912234 abstract "Abstract Aim Peritoneal surface malignancy (PSM) programmes offer curative options to previously terminal cases through cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, this requires special expertise and resources, which may not be available to low- and middle-income countries (LMIC). The study aims to document the Moroccan experience of a national PSM programme. Method This is a mixed method study involving the retrospective assessment of patients with PSM following CRS between 2004 and 2018, alongside interviewing the founding surgeons leading the programme establishment to depict the pitfalls, difficulties, and processes of a PSM programme creation. This operation extended on an initiation, transition, and consolidation phase. Progress was demonstrated by outcome comparison of incomplete cytoreductive surgery (ICRS) rate, serious complications ≥ 3b according to the Clavien-Dindo scoring, and early oncologic failure (EOF; disease progression within 2 years of treatment) between periods. Results In total, 198 CRS procedures were performed in the three phases with outcome assessment showing significantly better results with lower ICRS (34%, 18% and4% p=<0.001), serious complications (30.6%, 20% and11.2%, p=0.019), and EOF (38.8%, 23.3% and12.4% p=0.002). Programme founders highlighted the importance of project initiators’ motivation and leadership qualities, team readiness to overcome resource’ restrictions while improving their surgical expertise in CRS techniques, and collaborations development to reinforce multidisciplinary and institutional progress before adding HIPEC. Conclusions Implementing a PSM programme in a LMIC can be a challenging process, which motivation, training and good resources usability can help overcome." @default.
- W4312912234 created "2023-01-05" @default.
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- W4312912234 date "2022-08-19" @default.
- W4312912234 modified "2023-09-27" @default.
- W4312912234 title "854 The Establishment of a National Peritoneal Surface Malignancy Programme: The Success, Pitfalls and Difficulties of the Moroccan Experience" @default.
- W4312912234 doi "https://doi.org/10.1093/bjs/znac268.029" @default.
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