Fabio Carboni1, Orietta Federici2, Settimio Zazza2, Francesco Corona2, Fanny Massimi2, Isabella Sperduti3, Mario Valle2. 1. Peritoneal Tumours Unit, IRCCS, Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy. fabiocarb@tiscali.it. 2. Peritoneal Tumours Unit, IRCCS, Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy. 3. Biostatistics Unit, IRCCS, Regina Elena National Cancer Institute, Rome, Italy.
Abstract
PURPOSE: The objective of this study was to analyze the role of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy that has developed in the treatment of patients with peritoneal metastasis of non-primary origin. METHODS: Patients who underwent treatment for secondary gastrointestinal and ovarian malignancies over a 20-year period were reviewed. Survival curves were estimated by the Kaplan-Meier product limit method and the log-rank test was used to assess differences between subgroups. RESULTS: The study included 293 patients. The most common histology was ovarian cancer (56.3%). Median PCI was 16 and CC0-1 resection was obtained in 88.1% of cases. Grade III and IV complications occurred in 12 patients (4.1%) and 47 patients (16%), respectively. The 30- and 60-day mortality rate was 1.3% (4 patients) and 2.4% (7 patients). Five-year OS was 21.7%, 73.6%, 42.1%, and 0 for colorectal, appendiceal, ovarian, and gastric cancer (p = < 0.0001), respectively, whereas 5-year DFS was 12.4%, 48.4%, 24.3%, and 0 (p = < 0.0001), respectively. Survival outcomes were significantly higher for CC0 in each subgroup of patients. CONCLUSION: Despite being a complex procedure, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should be considered a safe treatment with acceptable postoperative morbidity and mortality rates, if performed in high-volume centers. Good survival outcomes have been increasingly obtained in selected patients with peritoneal metastasis of non-primary origin.
PURPOSE: The objective of this study was to analyze the role of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy that has developed in the treatment of patients with peritoneal metastasis of non-primary origin. METHODS: Patients who underwent treatment for secondary gastrointestinal and ovarian malignancies over a 20-year period were reviewed. Survival curves were estimated by the Kaplan-Meier product limit method and the log-rank test was used to assess differences between subgroups. RESULTS: The study included 293 patients. The most common histology was ovarian cancer (56.3%). Median PCI was 16 and CC0-1 resection was obtained in 88.1% of cases. Grade III and IV complications occurred in 12 patients (4.1%) and 47 patients (16%), respectively. The 30- and 60-day mortality rate was 1.3% (4 patients) and 2.4% (7 patients). Five-year OS was 21.7%, 73.6%, 42.1%, and 0 for colorectal, appendiceal, ovarian, and gastric cancer (p = < 0.0001), respectively, whereas 5-year DFS was 12.4%, 48.4%, 24.3%, and 0 (p = < 0.0001), respectively. Survival outcomes were significantly higher for CC0 in each subgroup of patients. CONCLUSION: Despite being a complex procedure, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should be considered a safe treatment with acceptable postoperative morbidity and mortality rates, if performed in high-volume centers. Good survival outcomes have been increasingly obtained in selected patients with peritoneal metastasis of non-primary origin.
Authors: Eliza W Beal; Ahmed Ahmed; Travis Grotz; Jennifer Leiting; Keith F Fournier; Andrew J Lee; Sean Dineen; Sophie Dessureault; Joel M Baumgartner; Jula Veerapong; Callisia Clarke; Erin Strong; Shishir K Maithel; Mohammad Y Zaidi; Sameer Patel; Vikrom Dhar; Ryan Hendrix; Laura Lambert; Fabian Johnston; Nadege Fackche; Mustafa Raoof; Christopher LaRocca; Sean Ronnekleiv-Kelly; Courtney Pokrzywa; Timothy M Pawlik; Sherif Abdel-Misih; Jordan M Cloyd Journal: Am J Surg Date: 2019-09-19 Impact factor: 2.565
Authors: Lee Shyang Kyang; Nayef A Alzahrani; Sarah J Valle; Mohamed K Rahman; Arif Arrowaili; Winston Liauw; David L Morris Journal: J Surg Oncol Date: 2019-07-16 Impact factor: 3.454
Authors: Jason M Foster; Richard Sleightholm; Asish Patel; Valerie Shostrom; Bradley Hall; Beth Neilsen; David Bartlett; Lynette Smith Journal: JAMA Netw Open Date: 2019-01-04