Long‐term survival outcomes of cytoreductive surgery and perioperative intraperitoneal chemotherapy: Single‐institutional experience with 1225 cases

• Published in: Journal of surgical oncology 2019-09, Vol.120 (4), p.794-802
• Main Authors: Kyang, Lee Shyang, Alzahrani, Nayef A., Valle, Sarah J., Rahman, Mohamed K., Arrowaili, Arif, Liauw, Winston, Morris, David L.
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Appendiceal Neoplasms - mortality; Appendiceal Neoplasms - pathology; Appendiceal Neoplasms - therapy; Cancer surgery; Chemotherapy; Chemotherapy, Cancer, Regional Perfusion - mortality; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; Combined Modality Therapy; Cytoreduction Surgical Procedures - mortality; cytoreductive surgery; EPIC; Female; Follow-Up Studies; HIPEC; Humans; Injections, Intraperitoneal; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Male; Mesothelioma; Mesothelioma - mortality; Mesothelioma - pathology; Mesothelioma - therapy; Mesothelioma, Malignant; Middle Aged; Ovarian cancer; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Perioperative Care; peritoneal metastasis; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - secondary; Peritoneal Neoplasms - therapy; Prognosis; Prospective Studies; Retrospective Studies; survival; Survival Rate
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.25642

Background and Objectives To review long‐term survival outcomes of patients with Peritoneal metastasis (PM) who underwent colorectal cancer (CRS) and intraperitoneal chemotherapy (PIC). Methods Patients that underwent CRS, with or without PIC, from January 1996 to March 2018 at the Peritonectomy Unit of St. George Hospital, Sydney were retrospectively analyzed from a prospectively maintained database. Results The study comprised of 1225 cases, including 687 females (56.1%) and 538 males (43.9%). Diagnoses included CRC (n = 363), followed by HAMN (n = 317), LAMN (n = 297), mesothelioma (n = 101), ovarian cancer (n = 55), and others including gastric, sarcoma, and neuroendocrine tumor (n = 92). The median OS, 5‐ and 10‐year survivals for CRC were 35 months, 33% and 8%, respectively. Patients with LAMN, in relative to HAMN, experienced a higher median OS, 5‐ and 10‐year survivals (248 months vs 63 months; 82% vs 52% and 59% vs 28%). The median OS for mesothelioma was 60 months with 5‐ and 10‐year survivals of 48% and 19%, respectively. In ovarian cancer, the median OS was 30 months with 5‐ and 10‐year survivals of 26% and 10%, respectively. For the remaining histological diagnoses, median OS and 5‐year survival were 28 months and 27%, respectively. Conclusion Our large‐cohort data showed that CRS/PIC can provide long‐term survival benefit to patients with PM of gastrointestinal and ovarian origin.