Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma: Multi-Institutional experience
演題番号 : MS8-3
This multi-institutional registry aimed to evaluate the outcome of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal carcinomatosis (PC) from small bowel adenocarcinoma (SBA).
Patients and Methods
A multi-institutional data registry that included 111 patients with PC from SBA treated by CRS and HIPEC was established. The primary end point was overall survival after CRS and HIPEC. The secondary end point was evaluation of prognostic variables for overall survival.
Follow-up was completed in 108 (97.3%) patients. The median follow-up period was 21 months (range, 1 to 95 months). There were 53 (49.1%) female patients, and the median age was 54 years (range, 29 to 78). Thirty-five (32.4%) patients had positive lymph node metastasis. The mean peritoneal cancer index (PCI) was 13. The median overall survival after CRS and HIPEC was 31 months (range, 1 to 95 months), with 1-, 3-, and 5-year survival rates were 80.2%, 45.7%, and 26.1%, respectively. Completeness of cytoreduciton (CCR) 0/1 was achieved in 77 (71.3%) patients. Eighty-three (76.9%) patients received HIPEC. Treatment-related mortality was 0.9%, and grade 3 to 4 operative complications occurred in 21 (21.6%) patients. Fifteen (13.9%) patients received a repeat CRS and HIPEC. Five prognostic factors were independently associated with improved survival in multivariate analysis: well differentiated tumor (P = 0.025), absence of lymph node metastasis (P= 0.024), PCI≤ 15 (P = 0.028), CCR0 (P = 0.016), and receipt of HIPEC (P = 0.017).
The combined treatment strategy of CRS and HIPEC achieved prolonged survival in selected patients with PC from SBA with acceptable morbidity and mortality.