Adjuvant Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for patients at High-Risk of Peritoneal Metastases.
Mackenzie C Morris, Vikrom K Dhar, Megan A Stevenson, Leah K Winer, Tiffany C Lee, Jiang Wang, Syed A Ahmad, Sameer H Patel, Jeffrey J Sussman, Daniel E Abbott
Author Information
Mackenzie C Morris: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Vikrom K Dhar: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Megan A Stevenson: Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Leah K Winer: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Tiffany C Lee: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jiang Wang: Department of Pathology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Syed A Ahmad: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Sameer H Patel: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jeffrey J Sussman: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Daniel E Abbott: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: abbott@surgery.wisc.edu.
BACKGROUND: Selection of patients for hyperthermic intraperitoneal chemotherapy (HIPEC) continues to evolve. We hypothesized that adjuvant HIPEC for patients at high-risk of peritoneal progression is safe and associated with favorable outcomes. METHODS: The institutional database of a high-volume center was queried for patients with high-risk disease undergoing HIPEC with a peritoneal carcinomatosis index (PCI) of 0. High-risk patients were defined as those with ruptured primary tumors or locally advanced (T) disease. RESULTS: 37 patients underwent adjuvant HIPEC, with a median follow-up of 5.2 years. 54% had low-grade (LG) tumors while 46% had high-grade (HG) tumors. No patients underwent neoadjuvant chemotherapy, while eleven patients (32.4%) received adjuvant chemotherapy. There were no perioperative mortalities, and the overall complication rate was 43%. For the entire cohort, five year recurrence-free survival (RFS) and overall survival (OS) were 77% and 100%, respectively. Five year RFS and OS were 75% and 100% for LG patients and 81% and 100% for HG patients, respectively. CONCLUSIONS: Adjuvant HIPEC for patients at high-risk of peritoneal progression, with PCI 0, is safe and associated with favorable long-term survival. Additional prospective investigation is needed to identify patient populations who may benefit most from HIPEC.
