Hyperthermic intraperitoneal chemotherapy after cytoreductive surgery for the treatment of peritoneal carcinomatosis in pediatric solid malignancies: a single institution experience

BackgroundPeritoneal carcinomatosis from abdominal tumors is an uncommon condition in children usually associated with dismal prognosis. Hyperthermic intraperitoneal chemotherapy (HIPEC) following complete macroscopic surgery has been demonstrated to be safe and of benefit in selected cases. Experience in pediatrics is scarce.MethodsWe retrospectively reviewed the medical files of patients under the age of 18 years with an abdominal malignancy and peritoneal carcinomatosis who had been treated with HIPEC in our institution between March 2001 and April 2012. HIPEC had been administered using the open technique with oxaliplatin (300 mg/m2) and irinotecan (200 mg/m2) or oxaliplatin alone (460 mg/m2) in the peritoneal cavity for 30 minutes at 43 °C and an intravenous perfusion of leucovorin (20 mg/m2) and 5-fluorouracil (400 mg/m2).ResultsNine patients had undergone HIPEC. Grade 3–4 complications had occurred in seven patients and were intraabdominal (n = 3) or extraabdominal (n = 8). No procedure-related deaths had occurred. Four patients are alive and in complete remission after a median follow-up of 4.9 years (1.7–9.6). However one relapsed after HIPEC and required additional salvage therapy.ConclusionsHIPEC could be considered in patients with peritoneal carcinomatosis from primary abdominal tumors. Its complications are manageable by an experienced multidisciplinary team. There are four long-term survivors, one after a relapse.