TY - JOUR
T1 - What made hyperthermic intraperitoneal chemotherapy an effective curative treatment for peritoneal surface malignancy
T2 - A 25-year experience with 1,125 procedures
AU - Passot, Guillaume
AU - Vaudoyer, Delphine
AU - Villeneuve, Laurent
AU - Kepenekian, Vahan
AU - Beaujard, Annie Claude
AU - Bakrin, Naoual
AU - Cotte, Eddy
AU - Gilly, Francois Noel
AU - Glehen, Olivier
N1 - Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Objective To review our 25-year experience with hyperthermic intra-peritoneal chemotherapy (HIPEC). Background Combining cytoreductive surgery (CRS) and HIPEC as local treatments for peritoneal carcinomatosis (PC) was proposed 25 years ago. Methods A prospective database of all patients undergoing HIPEC for PC since 1989 was searched for clinicopathological data, 90-day morbidity and mortality, and survival. Results Among 1,125 HIPEC procedures, PC origin was colorectal (342; 30%), ovarian (271; 24%), pseudomyxoma peritonei (189; 17%), gastric (127; 11%), malignant mesothelioma (84; 8%), or other (112; 10%). Between 2004-2009 (n = 321) and 2010-2015 (n = 560), the median peritoneal cancer index decreased (11 vs. 8; P < 0.001), fewer patients underwent incomplete cytoreduction (CC2-3: 4% vs. 0.5%; P < 0.001), and more were included in randomized trials (5% vs. 16%; P < 0.001). Postoperative morbidity (52% vs. 50%, P = 0.672) was not different, but mortality significantly decreased (5% vs. 2%; P = 0.030). Median overall-survival was 42 months, and improved significantly for each 5-year period except for 2006-2010 vs. 2011-2015 (P = 0.097). The 10-year survival without recurrence was 53%, 14%, 4%, 10%, and 9% for pseudomyxoma, mesothelioma, ovarian, colorectal, and gastric PC, respectively. Conclusion This study demonstrated that CRS and HIPEC provide long-term survival irrespective of PC origin, and survival improves with experience.
AB - Objective To review our 25-year experience with hyperthermic intra-peritoneal chemotherapy (HIPEC). Background Combining cytoreductive surgery (CRS) and HIPEC as local treatments for peritoneal carcinomatosis (PC) was proposed 25 years ago. Methods A prospective database of all patients undergoing HIPEC for PC since 1989 was searched for clinicopathological data, 90-day morbidity and mortality, and survival. Results Among 1,125 HIPEC procedures, PC origin was colorectal (342; 30%), ovarian (271; 24%), pseudomyxoma peritonei (189; 17%), gastric (127; 11%), malignant mesothelioma (84; 8%), or other (112; 10%). Between 2004-2009 (n = 321) and 2010-2015 (n = 560), the median peritoneal cancer index decreased (11 vs. 8; P < 0.001), fewer patients underwent incomplete cytoreduction (CC2-3: 4% vs. 0.5%; P < 0.001), and more were included in randomized trials (5% vs. 16%; P < 0.001). Postoperative morbidity (52% vs. 50%, P = 0.672) was not different, but mortality significantly decreased (5% vs. 2%; P = 0.030). Median overall-survival was 42 months, and improved significantly for each 5-year period except for 2006-2010 vs. 2011-2015 (P = 0.097). The 10-year survival without recurrence was 53%, 14%, 4%, 10%, and 9% for pseudomyxoma, mesothelioma, ovarian, colorectal, and gastric PC, respectively. Conclusion This study demonstrated that CRS and HIPEC provide long-term survival irrespective of PC origin, and survival improves with experience.
KW - HIPEC
KW - cytoreductive surgery
KW - experience
KW - long term survival
KW - peritoneal carcinomatosis
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U2 - 10.1002/jso.24248
DO - 10.1002/jso.24248
M3 - Article
C2 - 27110915
AN - SCOPUS:84964489844
SN - 0022-4790
VL - 113
SP - 796
EP - 803
JO - Journal of surgical oncology
JF - Journal of surgical oncology
IS - 7
ER -