A Comprehensive Treatment of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis: 3-Year Insights from National Cancer Institute, Thailand

Abstract

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has demonstrated significant survival benefits in peritoneal carcinomatosis (PC) across diverse cancer types, including gastrointestinal, ovarian, mesothelioma, and pseudomyxoma peritonei (PMP). However, variations in morbidity and mortality rates necessitate a comprehensive evaluation. This study aims to present concise insights into the short-term outcomes of CRS and HIPEC, drawing from a single institute experience. Patients who underwent CRS and HIPEC between November 2018 and August 2021 were identified, and their data were meticulously analyzed. The focus encompassed the clinical spectrum, surgical particulars, postoperative complications, and perioperative morbidity and mortality. Throughout the study period, 54 patients underwent CRS and HIPEC, with colorectal cancer accounting for the majority (46.3%), followed by ovarian cancer, gastric cancer, PMP, and malignant peritoneal mesothelioma. The average peritoneal cancer index stood at 14, with complete cytoreduction achieved in 79.6% of cases. Notably, 9.2% of patients experienced grade III and IV complications. Progression-free survival (PFS) demonstrated a median duration of 16.07 months (95% confidence interval, 8.59–23.54). The 1-, 2-, and 3-year survival rates were observed at 74%, 63%, and 43%, respectively. CRS and HIPEC are safe and feasible PC treatments for various cancers and should be recognized as important tools in advanced cancer therapy to achieve curation in a selected patient population.