Adjuvant Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for patients at High-Risk of Peritoneal Metastases.

Abstract

BACKGROUND:

Selection of patients for hyperthermic intraperitoneal chemotherapy (HIPEC) continues to evolve. We hypothesized that adjuvant HIPEC for patients at high-risk of peritoneal progression is safe and associated with favorable outcomes.

METHODS:

The institutional database of a high-volume center was queried for patients with high-risk disease undergoing HIPEC with a peritoneal carcinomatosis index (PCI) of 0. High-risk patients were defined as those with ruptured primary tumors or locally advanced (T4) disease.

RESULTS:

37 patients underwent adjuvant HIPEC, with a median follow-up of 5.2 years. 54% had low-grade (LG) tumors while 46% had high-grade (HG) tumors. No patients underwent neoadjuvant chemotherapy, while eleven patients (32.4%) received adjuvant chemotherapy. There were no perioperative mortalities, and the overall complication rate was 43%. For the entire cohort, five year recurrence-free survival (RFS) and overall survival (OS) were 77% and 100%, respectively. Five year RFS and OS were 75% and 100% for LG patients and 81% and 100% for HG patients, respectively.

CONCLUSIONS:

Adjuvant HIPEC for patients at high-risk of peritoneal progression, with PCI 0, is safe and associated with favorable long-term survival. Additional prospective investigation is needed to identify patient populations who may benefit most from HIPEC.

• Authors: Mackenzie C Morris, Vikrom K Dhar, Megan A Stevenson, Leah K Winer, Tiffany C Lee, Jiang Wang, Syed A Ahmad, Sameer H Patel, Jeffrey J Sussman, Daniel E Abbott
• Journal: Surgical oncology (Surg Oncol) Vol. 31 Pg. 33-37 (Dec 2019) ISSN: 1879-3320 [Electronic] Netherlands
• PMID: 31518971 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Chemotherapy, Adjuvant
• Chemotherapy, Cancer, Regional Perfusion (mortality)
• Combined Modality Therapy
• Cytoreduction Surgical Procedures (mortality)
• Female
• Follow-Up Studies
• Humans
• Hyperthermia, Induced (mortality)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (pathology, therapy)
• Neoplasms (pathology, therapy)
• Peritoneal Neoplasms (secondary, therapy)
• Prognosis
• Retrospective Studies
• Survival Rate