Palliative effects of an incomplete cytoreduction combined with perioperative intraperitoneal chemotherapy.
OBJECTIVE
Incomplete cytoreduction often occurs because of overwhelming burden of disease intraperitoneally that limit a successful cytoreduction. The outcome of an incomplete cytoreduction followed by administering perioperative intraperitoneal chemotherapy on whether it prolongs survival or palliates symptoms is yet to be established.


METHODS
A retrospective review of a prospectively collected database was performed. Eleven patients were identified to have had an incomplete (CC2/3) cytoreduction and received either hyperthermic intraperitoneal chemotherapy or early postoperative intraperitoneal chemotherapy. The symptoms of the patients before and after treatment during follow-up consultations in clinic were noted. Survival analysis was performed using the Kaplan Meier method.


RESULTS
The median follow-up period was 19 (range, 0.5-35) months. The overall median survival was 21 months with a 1- and 2-year survival rate of 72% and 36%, respectively. Five of 7 patients with pseudomyxoma peritonei and 2 of 3 patients with colorectal cancer peritoneal carcinomatosis experienced symptom improvement after treatment. Severe postoperative morbidity and achieving symptomatic improvement following treatment seems to be associated with a dismal prognosis.


CONCLUSIONS
Our results suggest that some patients derive a survival and symptomatic benefits despite an incomplete cytoreductive surgery and perioperative intraperitoneal chemotherapy. The effects of this treatment require further investigation to determine its benefits as a palliative procedure.
Chua
Terence C
TC
Department of Surgery, St George Hospital, University of New South Wales, Kogarah, Australia.
Baker
Bilal
B
Yan
Tristan D
TD
Zhao
Jing
J
Morris
David L
DL
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007263:Infusions, Parenteral; D053208:Kaplan-Meier Estimate; D007813:Laparotomy / Q000379:methods; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010166:Palliative Care; D019990:Perioperative Care; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents