Annals of Surgical Oncology

, Volume 15, Issue 10, pp 2701–2708

Hyperthermic Intraperitoneal Chemotherapy with Oxaliplatin for Peritoneal Carcinomatosis Arising from Appendix: Preliminary Results of a Survival Analysis

  • Eric Marcotte
  • Lucas Sideris
  • Pierre Drolet
  • Andrew Mitchell
  • Suzanne Frenette
  • Guy Leblanc
  • Yves E. Leclerc
  • Pierre Dubé
Gastrointestinal Oncology

Abstract

Background

Peritoneal carcinomatosis (PC) arising from the appendix is a rare disease for which the long-term prognosis is poor. The aim of this study was to evaluate the results of an aggressive approach used in our institution over the last 5 years.

Methods

Data from all patients with PC arising from the appendix were prospectively collected and analyzed. Treatment consisted in complete surgical cytoreduction followed by hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin (460 mg/m2) in 2 L/m2 of D5W at 43°C during 30 min. Ronnett’s histologic classification was used for tumor grading.

Results

From February 2003 to March 2007, 38 patients with PC arising from the appendix underwent laparotomy with curative intent. Mean follow-up was 23 months. Twenty-three patients received HIPEC but ten patients could not have complete cytoreductive surgery and received no HIPEC. Five patients with a negative second-look surgery also received no HIPEC. Three-year overall survival (OS) was 100% for the negative second-look patients, 86% for the HIPEC patients, and 29% for the unresectable patients (P = 0.0098). Three-year disease-free survival (DFS) was 49% for the HIPEC patients. Histologic grade was a prognostic factor with regard to DFS for the HIPEC patients (P = 0.011). There was one postoperative mortality. The overall major (grade III–V/V) complication rate for treated patients was 39%, including intra-abdominal abscess (22%), hemorrhage (18%), and anastomotic leak (9%).

Conclusion

Although these results are preliminary, this therapeutic approach seems both feasible and safe in selected patients.

Keywords

Peritoneal neoplasms Appendiceal neoplasms Hyperthermic intraperitoneal chemotherapy Oxaliplatin 

Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Eric Marcotte
    • 1
  • Lucas Sideris
    • 1
  • Pierre Drolet
    • 2
  • Andrew Mitchell
    • 3
  • Suzanne Frenette
    • 4
  • Guy Leblanc
    • 1
  • Yves E. Leclerc
    • 1
  • Pierre Dubé
    • 1
  1. 1.Division of General Surgical Oncology, Department of SurgeryHôpital Maisonneuve-Rosemont, Université de MontréalMontréalCanada
  2. 2.Department of AnesthesiologyHopital Maisonneuve-Rosemont, Université de MontréalMontréalCanada
  3. 3.Department of PathologyHopital Maisonneuve-Rosemont, Université de MontréalMontréalCanada
  4. 4.Department of PharmacyHopital Maisonneuve-Rosemont, Université de MontréalMontréalCanada

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