Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in management of peritoneal carcinomatosis: Single center experience in Korea

Abstract

Peritoneal carcinomatosis (PC) can result from either the direct dissemination of gastrointestinal and gynecological cancers or secondary metastasis along the peritoneal surface into the abdominal cavity [1-3]. In patients with a peritoneal metastasis only, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a potential curative option [4-6]. The basic concept of CRS/HIPEC involves first removing all macroscopic tumors and then delivering hyperthermic anticancer drugs to the microscopic residual tumor cells [7]. Verwaal et al. [8,9] performed a randomized controlled trial with 105 colorectal PC patients, with the median progression-free survival and the median disease-specific survival of 12.6 months and 22.2 months, respectively, in the CRS/HIPEC group, showing better survival than in the systemic chemotherapy only group. Furthermore, there are numerous reports of positive results of CRS/HIPEC in patients with PC [10,11]. Nevertheless, many surgeons are still concerned about the high morbidity and mortality of CRS/HIPEC. A number of reports have shown a 1.1%–4.8% mortality rate and 29.8%–43% grade III/ IV morbidity rate [10,12-14]. Thus, in this study, we would like to evaluate the 30-day clinical outcomes of CRS/HIPEC and the feaOriginal Article Korean Journal of Clinical Oncology 2019;15:61-67 https://doi.org/10.14216/kjco.19012 pISSN 1738-8082 ∙ eISSN 2288-4084