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Cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (HIPEC): Toxicity, survival, and prognostic variables in 130 patients with peritoneal carcinomatosis

Authors :
P. Pattyn
Marc Peeters
Philippe Houtmeyers
F De Somer
Christophe Breusegem
Wim Ceelen
Source :
Journal of Clinical Oncology. 25:15040-15040
Publication Year :
2007
Publisher :
American Society of Clinical Oncology (ASCO), 2007.

Abstract

15040 Background: Peritoneal carcinomatosis (PC) has a dismal prognosis. Cytoreductive surgery with HIPEC has been introduced in the management of PC with biologically favourable features. Methods: In an eight year period, 130 patients were treated (53% female, mean age 56±1 years). The origin of PC was colorectal cancer (CRC, 58%), pseudomyxoma peritonei (PMP, 9%), ovarian cancer (17%), primary peritoneal mesothelioma (10%) and gastric cancer (6%). Surgery was followed by HIPEC with mitomycin C (90 min, 35 mg/m2), oxaliplatin (30 min, 460 mg/m2) or cisplatin (90 min, 100–250 mg /m2) depending on tumour histology and previous systemic chemotherapy. The extent of disease was scored using a scale ranging from 0–9, while completeness of cytoreduction (CC) was scored as complete (CC0), nearly complete (CC1, miliary residual disease) or incomplete (CC2, gross residual disease). Target intraperitoneal temperature was 41°C-42°C. Actuarial survival was calculated using the Kaplan Meier method and univariate analysis performed using the log rank method. Results: Open perfusion (coliseum technique) was used in 41% of procedures. Macroscopically complete resection was achieved in 41%. Postoperative 30 day mortality was 1.5% while major morbidity developed in 18% of patients. Morbidity was mainly related to the extent of surgery. Median overall survival (months) was as follows: CRC, 20; PMP, 38; ovarian cancer, 19; gastric cancer, 10; mesothelioma, 9. Median survival was significantly better in CC0 patients (40 months) compared to CC1 (17 months) or CC2 (12 months). Survival was significantly worse in patients with ascites at surgery (p No significant financial relationships to disclose.

Details

ISSN :
15277755 and 0732183X
Volume :
25
Database :
OpenAIRE
Journal :
Journal of Clinical Oncology
Accession number :
edsair.doi...........987ab5055ffdf83638331a90aec3bfca
Full Text :
https://doi.org/10.1200/jco.2007.25.18_suppl.15040