Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: the Danish experience

Our plain-English summary of Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: the Danish experience, by L.H. Iversen, P.C. Rasmussen, R. Hagemann-Madsen, et al (Colorectal Disease, 2013).

The study

• Authors: L.H. Iversen, P.C. Rasmussen, R. Hagemann-Madsen, S. Laurberg
• Journal: Colorectal Disease
• Published: 2013;15(7):e365-72
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aim: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment option with curative intent for selected patients with peritoneal carcinomatosis (PC). CRS and HIPEC have been implemented in Denmark at a single centre since 2006. Six years of data on these patients were analysed.

Method: Patients with PC from colorectal or appendiceal cancer, pseudomyxoma peritonei or malignant peritoneal mesothelioma referred to the single national HIPEC centre were prospectively registered from June 2006 to July 2012. Morbidity, 30-day mortality and long-term survival of patients who underwent CRS and HIPEC were analysed.

Results: In total, 80 patients underwent CRS and HIPEC. PC originated from colorectal cancer in 34 patients, pseudomyxoma peritonei in 29, appendiceal cancer in 13 and malignant peritoneal mesothelioma in four patients. Thirty-two patients had one or more complications during the hospital stay. The 30-day mortality rate was 1.3%. The predicted 2-, 3- and 5-year survival was 60%, 47% and 38% in patients with PC from colorectal cancer, and 100%, 93% and 73% in pseudomyxoma peritonei patients.

Conclusion: CRS and HIPEC is a safe procedure when centralized as in Denmark. Favourable long-term outcome was achieved in selected patients with PC from colorectal cancer and pseudomyxoma peritonei. Short-term and long-term outcomes were comparable to results from international centres.

Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

In plain English

This article reported the first six years of a Danish national centre at Aarhus University Hospital. The centre offered cytoreductive surgery (removing visible tumour from the abdominal lining) followed by heated chemotherapy circulated through the abdomen (HIPEC). Patients treated from June 2006 to July 2012 were recorded as they were treated. Of the 80 patients who had the combined treatment, the cancer came from colorectal cancer in 34, from pseudomyxoma peritonei in 29, from appendiceal cancer in 13, and from malignant peritoneal mesothelioma in four. The chemotherapy was mitomycin C, except for the mesothelioma patients, who received cisplatin. Thirty-two patients (40.0%) had one or more complications in hospital, and one patient died within 30 days (1.3%). Predicted 2-, 3- and 5-year survival was 60%, 47% and 38% in the colorectal group and 100%, 93% and 73% in the pseudomyxoma group. Of the four mesothelioma patients, one died after 48.6 months. The authors concluded that the treatment was safe when centralized as in Denmark. They noted that follow-up was short. The article does not discuss asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Prospectively registered series of consecutive patients treated at a single national centre (surgical outcomes study)
• Who was studied: 80 patients with cancer spread in the abdominal lining (from colorectal cancer, appendiceal cancer, pseudomyxoma peritonei or malignant peritoneal mesothelioma) treated at the Danish national HIPEC centre, Aarhus University Hospital, June 2006 to July 2012
• Exposure: No asbestos exposure was studied. The study examined a treatment: cytoreductive surgery plus heated intraperitoneal chemotherapy with mitomycin C 35 mg/m2. Patients with malignant peritoneal mesothelioma received cisplatin 50 mg/m2 instead.
• Main results:
  • Of the 80 treated patients, the cancer came from colorectal cancer in 34, pseudomyxoma peritonei in 29, appendiceal cancer in 13 and malignant peritoneal mesothelioma in 4.
  • 32 of 80 patients (40.0%) had one or more complications during their hospital stay.
  • 30-day mortality among all 80 patients was 1.3%. This was one patient, who died 26 days after surgery at a local hospital.
  • Predicted 2-, 3- and 5-year survival in patients whose cancer came from colorectal cancer was 60%, 47% and 38%.
  • Predicted 2-, 3- and 5-year survival in pseudomyxoma peritonei patients was 100%, 93% and 73%.
  • Of the 4 malignant peritoneal mesothelioma patients, one died after 48.6 months. Median follow-up in this group was 12.1 months (range 7.0 to 48.6).
  • Of the 13 patients whose cancer came from appendiceal cancer, 2 died, after 20 and 60.6 months.
• The authors' conclusion: The authors concluded that cytoreductive surgery with HIPEC is safe when centralized as in Denmark, and that short- and long-term outcomes were comparable to results from international centres.
• Limitations the authors state:
  • The authors stated that median follow-up was short.
  • The authors described the study as small-scale.
  • Only four pseudomyxoma peritonei patients had high-grade disease, limiting the survival comparison by grade.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Cytoreductive Surgery, HIPEC, Peritoneal Mesothelioma, Colorectal Cancer.

Related studies

• Quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: a prospective study of 216 patients — G. Passot, N. Bakrin, et al. (2014)
• Evolution of locoregional treatment for peritoneal carcinomatosis: single-center experience of 308 procedures of cytoreductive surgery and perioperative intraperitoneal chemotherapy — T.C. Chua, W. Liauw, et al. (2011)
• The results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in 1200 patients with peritoneal malignancy — B. Moran, T. Cecil, et al. (2015)
• Quality of life in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is it worth the risk? — N. Tsilimparis, C. Bockelmann, et al. (2013)
• Value of laparoscopy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis — L.H. Iversen, P.C. Rasmussen, et al. (2013)
• Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy (HIPEC) by Minimally Invasive Approach, an Initial Experience — A. Arjona-Sanchez, S. Rufian-Peña, et al. (2018)

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