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The role of “closed abdomen” hyperthermic intraperitoneal chemotherapy (HIPEC) in the palliative treatment of neoplastic ascites from peritoneal carcinomatosis: report of a single-center experience

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Abstract

Purpose

The purpose of this study was to review the results of a single-center experience in the management of “closed abdomen” hyperthermic intraperitoneal chemotherapy (HIPEC) using a sophisticated technical device (EXIPER®) in the palliative setting of neoplastic ascites from peritoneal carcinomatosis in patients with advanced cancer of different primary sites.

Patients and methods

The study was an open, prospective, single-center, non-randomized study conducted at the Department of Medical Oncology 1, University of Cagliari, Italy, from May 2006 to October 2012. Fifteen patients with peritoneal carcinomatosis were treated with HIPEC: 5 males and 10 females (age range 51–82, median 62 years), for a total of 30 procedures (5 patients were treated more than once). Malignant ascites were from ovarian, uterine cervical, colorectal, gastric, malignant pleural mesothelioma, and unknown primary cancer. Main endpoints were increase of free interval between two consecutive procedures, progressive reduction of ascites volumes and improvement of quality of life assessed with ECOG performance status and EORTC QLQ-C30 questionnaire, and improvement of immunologic function.

Results

Twelve patients were completely evaluable while three patients were “lost” to follow-up. The treatment was well tolerated. The mean free interval between two consecutive drainages increased from 11.2 to 39.5 days. The mean ascites volume drained decreased from 7.8 to 1.8 l. ECOG PS improved in the majority of patients and EORTC QLQ-C30 scores in all patients as well as immunologic function. In September 2015, only one patient was still alive.

Conclusions

Our study shows that good results may be achieved in terms of symptom palliation and improvement of quality of life in very advanced cancer patients with MA from PC. The treatment was generally well tolerated considering the limited treatment options available for these patients.

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Abbreviations

CS:

Cytoreductive surgery

HIPEC:

Hyperthermic intraperitoneal chemotherapy

IP:

Intraperitoneal

MA:

Malignant ascites

PC:

Peritoneal carcinomatosis

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Authors and Affiliations

  1. Department of Medical Oncology, University of Cagliari, Cagliari, Italy

    L. Orgiano, G. Astara, C. Madeddu & Giovanni Mantovani

  2. Endocrinology Unit, University of Cagliari, Cagliari, Italy

    F. Pani

  3. Radiology Unit, University of Cagliari, Cagliari, Italy

    S. Marini

  4. General Surgery, University of Cagliari, Cagliari, Italy

    A. Manca

Authors
  1. L. Orgiano
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  2. F. Pani
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  3. G. Astara
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  4. C. Madeddu
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  5. S. Marini
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  6. A. Manca
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  7. Giovanni Mantovani
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Corresponding author

Correspondence to Giovanni Mantovani.

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Conflict of interest

The authors declare that they have no conflict of interest. We confirm that we have full control of all primary data and we agree to allow the Journal of Supportive Care in Cancer to review our data if requested.

Additional information

Giovanni Mantovani is a Former Full Professor of Medical Oncology, University of Cagliari.

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Orgiano, L., Pani, F., Astara, G. et al. The role of “closed abdomen” hyperthermic intraperitoneal chemotherapy (HIPEC) in the palliative treatment of neoplastic ascites from peritoneal carcinomatosis: report of a single-center experience. Support Care Cancer 24, 4293–4299 (2016). https://doi.org/10.1007/s00520-016-3262-7

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  • DOI: https://doi.org/10.1007/s00520-016-3262-7

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