Initial experience with hyperthermic intra peritoneal chemotherapy and cytoreductivesurgery.
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Date
2014-04
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Abstract
BACKGROUND: Promising results were reported with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in
peritoneal carcinomatosis. Experiences in India are not published. This is a preliminary report. MATERIALS AND METHODS: From eight patients
with peritoneal metastasis, six patients (5 M, 1 F), aged (40‑62 years) were treated with CRS and HIPEC between May 2010 and August 2011
from a single institution. Three had Mucinous Adenocarcinoma of Appendix and one each with Mesothelioma, Ovarian Cancer and Colonic
Cancer. Four were earlier treated with systemic chemotherapy and recurred. Pre‑operative peritoneal cancer index (PCI) was calculated
based on recent computerized tomography or positron emission tomography scans. Surgical completeness cytoreduction score (CCS) was
classified as macroscopically complete (CCS‑0); optimal residual disease ≤2.5 mm in any region (CCS‑1); or grossly incomplete: Residual
disease >2.5 mm (CCS‑2) or >25 mm (CCS‑3). They were treated by closed perfusion technique with mitomycin‑C (MCC) and cisplatin at 41‑42°C,
for 60 min. RESULTS: Optimal cytoreduction (residual tumor nodules <2.5 mm i.e. CC0 and CC1) was performed in four patients (66.67%). There
was no operative mortality or Grade 3 and 4 toxicity. Patients with PCI <11 are alive without recurrence with overall survival of 26‑31 months.
Those with PCI >11 had recurrence with overall survival of 3‑19 months. Two patients died at 3 and 9 months. CONCLUSION: CRS and HIPEC is
a promising therapeutic option in selected patients with peritoneal carcinomatosis. These results in six patients are preliminary but encouraging.
Patient with low PCI had better disease free survival.
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Cytoreduction, hyperthermic intra peritoneal chemotherapy, hyperthermic chemotherapy, peritoneal carcinomatosis
Citation
Dharmadhikari N, Shah R, Jagannath P. Initial experience with hyperthermic intra peritoneal chemotherapy and cytoreductivesurgery. Indian Journal of Cancer. 2014 Apr-Jun; 51(2): 189-192.