Long‐term survival following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Waikato, Aotearoa New Zealand: a 12‐year experience

• Published in: ANZ journal of surgery 2024-04, Vol.94 (4), p.621-627
• Main Authors: Qin, Rennie Xinrui, Lim, Jia Hui, Ly, Jasen, Fischer, Jesse, Smith, Nicholas, Karalus, Mosese, Wu, Linus, Dalen, Roelef, Lolohea, Simione
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - pathology; Appendiceal Neoplasms - pathology; Cancer; Carcinoma; Chemotherapy; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - pathology; Combined Modality Therapy; Cytoreduction Surgical Procedures - methods; cytoreductive surgery; Female; HIPEC; Hospitals; Humans; Hyperthermia, Induced - methods; Hyperthermic Intraperitoneal Chemotherapy; Malignancy; Metastases; Mucin; Neoplasms; New Zealand - epidemiology; Ovarian cancer; Ovaries; Patients; Peritoneal Neoplasms - secondary; peritoneal surface malignancy; Peritoneum; Pseudomyxoma Peritonei - surgery; Retrospective Studies; Surgery; Survival; Survival Rate
• ISSN: 1445-1433; 1445-2197; 1445-2197
• DOI: 10.1111/ans.18777

Backgrounds Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have improved survival for selected cases of peritoneal surface malignancy. In 2008, a CRS/HIPEC service was first established in Aotearoa New Zealand (AoNZ) at Waikato and Braemar Hospitals in the Waikato region. Methods This is a retrospective review of a prospectively maintained database of all patients undergoing CRS/HIPEC from 1 January 2008 to 1 November 2020 at Waikato and Braemar Hospitals. We analysed long‐term survival and predictors of survival for each tumour type. Results 240 procedures were performed for 221 patients, including 22 re‐do procedures. Cases had a median peritoneal cancer index of 16. Complete cytoreduction (CC0‐1) was achieved in 196 cases (81.7%). All complete cytoreduction cases received HIPEC. There were 152 pseudomyxoma peritonei (PMP), 39 colorectal cancers (CRC), 29 appendiceal cancers, eight ovarian cancers, six peritoneal mesotheliomas, and six other cancers. The 5‐year overall survival (OS) for PMP with acellular mucin, low‐grade mucinous carcinoma peritonei, and high‐grade mucinous carcinoma peritonei with or without signet cells were 91.6%, 80.5%, and 72.2%, respectively. 2‐ and 5‐year OS in CRC were 56.7% and 40.4%. The achievement of complete cytoreduction improved the 5‐year OS to 87.9% across all PMP and 45.1% in colorectal cancer. Incomplete cytoreduction predicted worse survival in appendiceal PMP. In colorectal cancer, worse survival was predicted in those who had incomplete cytoreduction, liver metastasis, and presentation with obstruction and perforation. Conclusion Favourable long‐term outcomes following CRS/HIPEC for peritoneal surface malignancy have been achieved in AoNZ through the Waikato peritonectomy service. In 2008, a cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) service for peritoneal surface malignancy was first established in Aotearoa New Zealand at Waikato and Braemar Hospitals in the Waikato region. This is a retrospective review of 221 patients undergoing 240 CRS/HIPEC procedures from 1 January 2008 to 1 November 2020. Favourable long‐term outcomes following CRS/HIPEC for peritoneal surface malignancy have been achieved in AoNZ through the Waikato peritonectomy service