Swedish experience with peritonectomy and HIPEC: HIPEC in peritoneal carcinomatosis
2008 (English)In: Annals of Surgical Oncology, ISSN 1068-9265, Vol. 15, no 3, 745-53 p.Article in journal (Refereed) Published
BACKGROUND: Peritonectomy with heated intraperitoneal chemotherapy (HIPEC) has shown a survival benefit in selected patients with peritoneal carcinomatosis. This prospective non-randomized study was designed to identify factors associated with postoperative morbidity and survival after peritonectomy HIPEC in patients with this condition. METHOD: Data were prospectively collected from all patients with peritoneal carcinomatosis treated by means of peritonectomy and HIPEC at Uppsala University Hospital between October 2003 and September 2006. Depending on the primary tumor, mitomycin C or a platinum compound was used as a chemotherapeutic agent for perfusion. RESULTS: A total of 103 patients were treated. Primary tumors were pseudomyxoma peritonei (47 patients), colorectal cancer (38 patients), gastric cancer (6 patients), ovarian cancer (6 patients) and mesothelioma (5 patients). Postoperative morbidity was 56.3% and was significantly lower in patients treated with mitomycin C for pseudomyxoma peritonei (42%) than in those with another diagnosis treated with platinum compound (71%, P < 0.05). Postoperative mortality was less than 1%. At 2 years, overall survival was estimated to be 72.3%, and disease-free survival was 33.5%. Factors influencing overall and disease-free survival were tumor type and optimal cytoreduction. CONCLUSION: Postoperative morbidity is dependent mainly on a tumor type; however, the chemotherapeutic agent used might also influence morbidity. Survival is determined by optimal cytoreduction and tumor type. Irrespective of age, patients with good performance status benefit from this treatment.
Place, publisher, year, edition, pages
2008. Vol. 15, no 3, 745-53 p.
Adolescent, Adult, Aged, Antineoplastic Agents/*administration & dosage, Chemotherapy; Cancer; Regional Perfusion, Humans, Hyperthermia; Induced, Infusions; Parenteral, Middle Aged, Mitomycin/administration & dosage, Peritoneal Neoplasms/*drug therapy/mortality/*surgery, Peritoneum/surgery, Platinum Compounds/administration & dosage, Prospective Studies, Survival Analysis, Sweden
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-16785DOI: 10.1245/s10434-007-9700-5ISI: 000252990700013PubMedID: 18057988OAI: oai:DiVA.org:uu-16785DiVA: diva2:44556