Long term survival analysis after hyperthermic intraperitoneal chemotherapy with oxaliplatin as a treatment for appendiceal peritoneal carcinomatosis

Surg Oncol. 2019 Mar:28:69-75. doi: 10.1016/j.suronc.2018.11.006. Epub 2018 Nov 13.

Abstract

Background and objectives: Complete cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) have been proven to lengthen survival in appendiceal peritoneal carcinomatosis (PC-A). The aim of this study was to analyze survival results of this therapy in our institution over the last 10 years.

Methods: Data was retrospectively reviewed and analyzed. Treatment consisted of CRS plus HIPEC with oxaliplatin. Ronnett's histologic classification was used (peritoneal mucinous carcinomatosis (PMCA), PMCA with intermediate features (PMCA-I) and disseminated peritoneal adenomucinosis (DPAM)). Overall survival (OS) and disease-free survival (DFS) estimates were calculated using Kaplan-Meier survival curves.

Results: 109 patients with PC-A underwent laparotomy with curative intent. Of those, 92 underwent CRS plus HIPEC. Median follow-up was 42 months. The 5 and 10-year OS rates for the HIPEC group were 82.2% and 76.5%. The 5 and 10-year OS estimates for DPAM and PMCA-I subgroups were 100% and 100%, 78.1% and 72.9%, respectively. For the PMCA subgroup, the 3 and 5-year OS were 61.4% and 40.1%, respectively. The 5 and 10-year DFS estimates were 71.9% and 42.7%.

Conclusion: CRS plus HIPEC with oxaliplatin represent an effective therapeutic approach for PC-A. Long term OS estimates for patients treated at our institution are encouraging.

Keywords: Appendiceal neoplasms/therapy; Peritoneal neoplasms/therapy; Pseudomyxoma peritonei/therapy.

MeSH terms

  • Adenocarcinoma, Mucinous / mortality*
  • Adenocarcinoma, Mucinous / secondary
  • Adenocarcinoma, Mucinous / therapy
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Appendiceal Neoplasms / mortality*
  • Appendiceal Neoplasms / pathology
  • Appendiceal Neoplasms / therapy
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / mortality*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Oxaliplatin / therapeutic use*
  • Peritoneal Neoplasms / mortality*
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / therapy
  • Prognosis
  • Retrospective Studies
  • Survival Rate

Substances

  • Antineoplastic Agents
  • Oxaliplatin