{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T13:53:57Z","timestamp":1775224437192,"version":"3.50.1"},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  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\u20134) was similar in both groups (G1: 21.4%, G2: 29.2%; p=0.947). No 30- or 90-day mortality occurred. Transfusions of \u22653 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&lt;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.<\/jats:p>","DOI":"10.1590\/1806-9282.20250905","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T13:08:39Z","timestamp":1775221719000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of learning curve on outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer patients at a specialized center"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6526-1821","authenticated-orcid":false,"given":"Vural","family":"Arg\u0131n","sequence":"first","affiliation":[{"name":"University of Health Sciences,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6527-506X","authenticated-orcid":false,"given":"\u00d6mer","family":"\u00d6zduman","sequence":"additional","affiliation":[{"name":"University of Health Sciences,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5564-6923","authenticated-orcid":false,"given":"Ahmet Orhan","family":"Sunar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9909-1840","authenticated-orcid":false,"given":"G\u00fclten \u00c7i\u00e7ek","family":"Okuyan","sequence":"additional","affiliation":[{"name":"Haydarpa\u015fa Numune Training and Research Hospital,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0276-0543","authenticated-orcid":false,"given":"Mustafa","family":"Duman","sequence":"additional","affiliation":[{"name":"University of Health Sciences,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9463-9846","authenticated-orcid":false,"given":"Erdal","family":"Polat","sequence":"additional","affiliation":[{"name":"University of Health Sciences,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"13","key":"ref1","doi-asserted-by":"crossref","first-page":"4224","DOI":"10.1245\/s10434-013-3145-9","article-title":"Cytoreduction and HIPEC in the Netherlands: nationwide long-term outcome following the Dutch protocol.","volume":"20","author":"Kuijpers AM","year":"2013","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"ref2","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/S1470-2045(20)30599-4","article-title":"Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial.","volume":"22","author":"Qu\u00e9net F","year":"2021","journal-title":"Lancet Oncol"},{"issue":"6","key":"ref3","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/SLA.0b013e31827e9289","article-title":"Is there a possibility of a cure in patients with colorectal peritoneal carcinomatosis amenable to complete cytoreductive surgery and intraperitoneal chemotherapy?","volume":"257","author":"Go\u00e9r\u00e9 D","year":"2013","journal-title":"Ann Surg"},{"issue":"561","key":"ref4","first-page":"75","article-title":"Cytoreductive surgery and intraperitoneal chemotherapy with peritoneal spread of cystadenocarcinoma.","volume":"561","author":"Sugarbaker PH","year":"1991","journal-title":"Eur J Surg Suppl"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3109\/07357907.2012.654871","article-title":"Peritoneal carcinomatosis: cytoreductive surgery and HIPEC--overview and basics.","volume":"30","author":"Br\u00fccher BL","year":"2012","journal-title":"Cancer Invest"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/j.ejso.2015.09.005","article-title":"Cytoreductive surgery with a hyperthermic intraperitoneal chemotherapy program: safe after 40 cases, but only controlled after 140 cases.","volume":"41","author":"Voron T","year":"2015","journal-title":"Eur J Surg Oncol"},{"issue":"24","key":"ref7","doi-asserted-by":"crossref","first-page":"5608","DOI":"10.1002\/cncr.25356","article-title":"Toward curative treatment of peritoneal carcinomatosis from nonovarian origin by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy: a multi-institutional study of 1,290 patients.","volume":"116","author":"Glehen O","year":"2010","journal-title":"Cancer"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1002\/jso.23231","article-title":"Learning curve for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal surface malignancies: analysis of two centres.","volume":"107","author":"Kusamura S","year":"2013","journal-title":"J Surg Oncol"},{"issue":"15_Suppl","key":"ref9","doi-asserted-by":"crossref","first-page":"e17512","DOI":"10.1200\/JCO.2018.36.15_suppl.e17512","article-title":"Factors predicting learning curve, morbidity, mortality, and outcomes: a prospective phase III study of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancy\u2014first Indian study.","volume":"36","author":"Somashekhar SP","year":"2018","journal-title":"J Clin Oncol"},{"issue":"4","key":"ref10","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/jso.21059","article-title":"The Delphi approach to attain consensus in methodology of local regional therapy for peritoneal surface malignancy.","volume":"98","author":"Kusamura S","year":"2008","journal-title":"J Surg 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colorectal peritoneal metastasis undergoing cytoreductive surgery and heated intraperitoneal chemotherapy.","volume":"3","author":"Hallam S","year":"2019","journal-title":"BJS Open"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2147\/CMAR.S119569","article-title":"Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer.","volume":"9","author":"Simkens GA","year":"2017","journal-title":"Cancer Manag Res"},{"issue":"9","key":"ref15","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.3390\/cancers12092387","article-title":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies: learning curve based on surgical and oncological outcomes.","volume":"12","author":"Mielko J","year":"2020","journal-title":"Cancers 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