Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal sarcomatosis: long-term outcome from a single institution experience.

Aim: We assessed the long-term local disease-free survival (LDFS) and overall survival (OS) of patients with peritoneal sarcomatosis (PS) uniformly-treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CS plus HIPEC).

Patients And Methods: Retrospective data of 15 patients who underwent CS plus HIPEC for PS were extracted from a prospectively collected database. DFS and OS were calculated from the date of CS plus HIPEC to local relapse and death, respectively.

Results: After a median follow-up of 28 months (range=4-144 months), median LDFS was 15 months (95% Confidence Interval CI=1-40 months). Median OS was 27 (95% CI=24.7-29.3) months. Long-term OS was achieved in three patients (20%) and ranged between 93 and 144 months. Female sex was the only factor significantly correlated with a greater LDFS (p=0.018). Patients with PS of visceral origin seem at lower risk of recurrence and death but the difference did not prove significant.

Conclusion: In our series, long-term survival was achieved in 20% of patients after CS plus HIPEC, with a benefit in female patients with PS of visceral origin. The impact of HIPEC after radical surgery for PS remains questionable and still has to be further evaluated in large cooperative multi-institutional studies.