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Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal metastasis of non-primary origin

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Abstract

Purpose

The objective of this study was to analyze the role of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy that has developed in the treatment of patients with peritoneal metastasis of non-primary origin.

Methods

Patients who underwent treatment for secondary gastrointestinal and ovarian malignancies over a 20-year period were reviewed. Survival curves were estimated by the Kaplan–Meier product limit method and the log-rank test was used to assess differences between subgroups.

Results

The study included 293 patients. The most common histology was ovarian cancer (56.3%). Median PCI was 16 and CC0-1 resection was obtained in 88.1% of cases. Grade III and IV complications occurred in 12 patients (4.1%) and 47 patients (16%), respectively. The 30- and 60-day mortality rate was 1.3% (4 patients) and 2.4% (7 patients). Five-year OS was 21.7%, 73.6%, 42.1%, and 0 for colorectal, appendiceal, ovarian, and gastric cancer (p =  < 0.0001), respectively, whereas 5-year DFS was 12.4%, 48.4%, 24.3%, and 0 (p =  < 0.0001), respectively. Survival outcomes were significantly higher for CC0 in each subgroup of patients.

Conclusion

Despite being a complex procedure, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should be considered a safe treatment with acceptable postoperative morbidity and mortality rates, if performed in high-volume centers. Good survival outcomes have been increasingly obtained in selected patients with peritoneal metastasis of non-primary origin.

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Author information

Authors and Affiliations

  1. Peritoneal Tumours Unit, IRCCS, Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy

    Fabio Carboni, Orietta Federici, Settimio Zazza, Francesco Corona, Fanny Massimi & Mario Valle

  2. Biostatistics Unit, IRCCS, Regina Elena National Cancer Institute, Rome, Italy

    Isabella Sperduti

Authors
  1. Fabio Carboni
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  2. Orietta Federici
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  3. Settimio Zazza
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  4. Francesco Corona
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  5. Fanny Massimi
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  6. Isabella Sperduti
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  7. Mario Valle
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Contributions

Study conception and design: F Carboni, M Valle. Acquisition of data: F Carboni, F Massimi, O Federici, S Zazza, F Corona, M Valle. Analysis and interpretation of data: F Carboni, M Valle, I Sperduti. Drafting the manuscript: F Carboni. Critical revision of the manuscript: F Carboni, M Valle.

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Correspondence to Fabio Carboni.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Carboni, F., Federici, O., Zazza, S. et al. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal metastasis of non-primary origin. Langenbecks Arch Surg 406, 2817–2825 (2021). https://doi.org/10.1007/s00423-021-02354-y

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