Treatment of Peritoneal Carcinomatosis withCytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Personal Experience of the First 100 Cases

Introduction: Intraperitoneal hyperthermic chemoperfusion has been proposed for treatment of peritoneal carcinomatosis from abdominal neoplasms. Methods: Data from the first 100 HIPEC carried out in our institution are prospectively revised. Results: Among 95 pts primary tumor was ovarian cancer in 52, gastric cancer in 16, colorectal carcinoma in 22, pseudomyxoma/mesothelioma in 6. A complete cytoreduction was obtained in 61% of cases. Postoperative complications occurred in 35% and haematological toxicity in 23%. The most frequent complications were wound infection (10 cases), pleural effusion (9 cases), intestinal fistula (9 cases) and medical complications (5 cases). Reoperation was necessary in five cases (5%). All complications solved favourably, except one postoperative mortality (1%). Five-yr survival rates were 51% for ovarian cancer, 47% for colorectal cancer, and 23% for gastric cancer. Long-term survival was also primarily related to the absence of residual tumor after cytoreduction. Discussion: Cytoreductive surgery combined with HIPEC is associated with a high risk of postoperative complications, and should be only performed in specialized centers. With an adequatemanagement, complications solved favourably in the majority of cases. High survival rates were observed in patients with PC from primary ovarian cancer and colorectal cancer with optimal cytoreduction.