Outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of primary peritoneal carcinoma
DOI:
https://doi.org/10.4081/joper.2017.57Keywords:
Primary peritoneal carcinoma, cytoreductive surgery, HIPEC, outcomesAbstract
Primary peritoneal carcinoma (PPC) is rare tumor, traditionally treated with surgical debulking and systemic chemotherapy (SC) with 30% five-year survival rate. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) may improve long-term survival. Thirty patients with PPC were identified. Twenty-three patients underwent CRS/HIPEC as initial treatment (group I) and 7 for recurrent disease (group II). Peritoneal cancer index (PCI), cytoreduction scores (CC), overall survival (OS) and progressionfree survival (PFS) were estimated using Kaplan-Meier survival analysis. FIGO stages II/III/IV at diagnosis were 2/20/7 (1 was not classified). Median time from diagnosis to CRS/HIPEC was 2 months and 8 months in groups I and II, respectively. PCI≥20 was seen in 16 (70%) and 4 (57%) in groups I and II, respectively. Complete cytoreduction (CC 0-1) was achieved in 30/32 (94%) CRS/HIPEC procedures. Median follow-up was 39 months (range: 11-250). PFS at 1, 3, 5-years was 80%, 75%, 59%, respectively. OS 1, 3, 5- years from CRS/HIPEC was 90%, 68%, 55%. CRS/HIPEC and adjuvant SC provides five-year survival rate higher than previously reported for PPC patients who received conventional therapy with surgical debulking and SC.
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