Repeat cytoreductive surgery with or without perioperative intraperitoneal chemotherapy for peritoneal surface malignancy

•Repeat CRS with or without PIC is feasible with acceptable mortality and morbidity rates.•Repeat CRS can provide survival benefits for patients with peritoneal surface malignancy.•Repeat CRS was identified as an independent prognostic factor for survival and DFS.

BackgroundA significant proportion of patients with peritoneal surface malignancy (PSM) experienced recurrence after initial cytoreductive surgery (CRS). Thus the aims of this study were to determine short-term outcomes and long-term survivals associated with repeat CRS.MethodsThis was a retrospective study of prospectively collected data of consecutive patients with PSM who underwent CRS by one surgical team at St George Hospital in Sydney, Australia between Jan 1996 and May 2016.ResultsThere was no significant difference in hospital mortality (p=0.343) and major morbidity rate (p=0.454). Patients who underwent repeat surgery had a significantly higher 5-year overall survival (OS) rate (p<0.001) and a longer median disease free interval (DFS) (p<0.001). Repeat CRS was also found to be a significant prognostic factor for OS (p<0.001) and DFS (p<0.001).ConclusionsRepeat CRS with or without perioperative intraperitoneal chemotherapy could provide long-term survival benefits to patients with PSM with acceptable mortality and morbidity rates.Summary1. Repeat CRS with or without PIC provides long-term survival benefits to patients with PSM. 2. Repeat CRS with or without PIC is feasible and can be performed without acceptable mortality and morbidity rates.