Learning Curve, Training Program, and Monitorization of Surgical Performance of Peritoneal Surface Malignancies Centers

Shigeki Kusamura, Santiago González-Moreno, Eran Nizri, Dario Baratti, Stefano Guadagni, Marcello Guaglio, Luigi Battaglia, Marcello Deraco

Research output: Contribution to journalReview article


Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a complex procedure with high cost and significant morbidity and mortality. The associated learning curve is steep and could reliably be evaluated using specific statistics. Risk-adjusted sequential probability ratio test is an effective and robust method to monitor surgical performance in the learning and audit phase of a peritoneal surface malignancies center development. The most critical factor associated with surgical performance is mentoring of the trainee by an expert. A well-structured tutor-based training program has been implemented in Europe. This initiative will improve the standardization of the combined procedure and improve quality of services across the continent.

Original languageEnglish
Pages (from-to)507-517
Number of pages11
JournalSurgical Oncology Clinics of North America
Issue number3
Publication statusPublished - Jul 2018



  • Cytoreduction Surgical Procedures/methods
  • Education
  • Humans
  • Learning Curve
  • Monitoring, Physiologic
  • Patient Outcome Assessment
  • Peritoneal Neoplasms/surgery

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