Long-term follow-up in the treatment of peritoneal carcinomatosis

BackgroundThe objective of this study was to report a long-term survival analysis of a phase II protocol of cytoreductive surgery (CS) and heated intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal carcinomatosis (PCs).MethodsBetween 2000 and 2008, 101 consecutive patients were treated with CS, HIPEC and early postoperative intraperitoneal chemotherapy using a standardized protocol. Disease recurrence and mortality data were collected prospectively. Primary outcomes were median, 3-year, and 5-year disease-free survival (DFS) and overall survival (OS).ResultsThe median age was 49 years (range, 18–77 years), and the majority (82%) had complete CS with no gross residual cancer. Tumor types included appendiceal (n = 58), colorectal (n = 31), and other (n = 12). Median follow-up was 28 months (range, 0–119 months), with minimum of 24 months among survivors. For appendiceal tumors, median DFS was 34 months (range, 0–119 months) and OS has not yet been defined. Three-year and 5-year DFS was 48% and 42%, respectively, and 3-year and 5-year OS was 76% and 62%, respectively. For colorectal carcinomatosis, median disease-free and OS was 9 months (range, 0–87 months) and 27 months (range, 0–87 months), respectively. Three-year and 5-year DFS was 34% and 26%, respectively, and 3-year and 5-year OS was 38% and 34%, respectively.ConclusionsLong-term survival with regional treatment of PC from appendiceal or colorectal primary tumors with CS and HIPEC is achievable.