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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Asian Patients: 100 Consecutive Patients in a Single Institution

  • Gastrointestinal Oncology
  • Published:
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Abstract

Background

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been shown to improve survival in selected patients with peritoneal carcinomatosis. We review our institutional experience with the procedure and evaluate the overall survival (OS) and disease-free survival (DFS) rates in 100 consecutive patients.

Methods

Data were prospectively collected from 100 consecutive patients with peritoneal carcinomatosis treated by CRS and HIPEC at the National Cancer Centre Singapore between April 2001 and May 2012. Our primary end points were OS and DFS.

Results

Of the 100 patients, 84 were of Chinese ethnicity, 3 were Malay, 6 were Indian, and 7 were of other ethnicities. Primary tumors were ovarian cancer (n = 39), colorectal cancer (n = 28), primary peritoneal (n = 6), appendiceal cancer (n = 20), and mesothelioma (n = 7). Median follow-up duration was 21 months. At 5 years, the DFS was 26.3 % and OS was 50.9 %. Factors influencing OS and DFS were cytoreductive score, primary cancer, and disease-free interval of more than 12 months on univariate analysis. The only factors that remained significant for prognosis after multivariate analysis were primary cancer and cytoreductive score. Thirty-day morbidity was 56 %, and there were no 30-day mortalities.

Conclusions

CRS and HIPEC can be safely carried out in Asian patients with peritoneal carcinomatosis from ovarian, colorectal, appendiceal, mesothelioma, and primary peritoneal origins. Overall, the ovarian, appendiceal, mesothelioma, and primary peritoneal cancer patients tended to do better than the colorectal patients, but careful patient selection ensuring that optimal cytoreduction can be achieved is essential for the success of this procedure.

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Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore

    Melissa Ching Ching Teo MBBS, FRCS, MPH

  2. Department of General Surgery, Singapore General Hospital, Singapore, Singapore

    Melissa Ching Ching Teo MBBS, FRCS, MPH & Grace Hwei Ching Tan MBBS, MRCS

  3. Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore

    Chee Kian Tham MBBS, MRCP, FRCP

  4. National Cancer Centre Singapore, Singapore, Singapore

    Cindy Lim & Khee Chee Soo MBBS, MD, FRACS

Authors
  1. Melissa Ching Ching Teo MBBS, FRCS, MPH
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  2. Grace Hwei Ching Tan MBBS, MRCS
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  3. Chee Kian Tham MBBS, MRCP, FRCP
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  4. Cindy Lim
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  5. Khee Chee Soo MBBS, MD, FRACS
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Corresponding author

Correspondence to Melissa Ching Ching Teo MBBS, FRCS, MPH.

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Teo, M.C.C., Tan, G.H.C., Tham, C.K. et al. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Asian Patients: 100 Consecutive Patients in a Single Institution. Ann Surg Oncol 20, 2968–2974 (2013). https://doi.org/10.1245/s10434-013-2947-0

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  • DOI: https://doi.org/10.1245/s10434-013-2947-0

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