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Updated: Aug 7, 2026
Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
Published on: July 31, 2016
An Italian Multicentric Phase II study on peritonectomy and intra peritoneal hyperthermic perfusion (IPHP) to treat
M Deraco1, M De Simone, C R Rossi
1Dept. of Surgery, Melanoma Sarcoma Unit, Istituto Nazionale per lo studio e la cura dei tumori, Milan Italy. marcello.deraco@istitutotumori.mi.it
Abstract:
Pseudomyxoma peritonei (PMP) is a rare disease with a poor prognosis when not adequately treated. It is characterized by a complete redistribution of mucin within the peritoneal cavity. The aim of this multicentric study was to evaluate the survival, morbidity, toxicity and mortality of patients with PMP treated by cytoreductive surgery (CRS) with intraperitoneal hyperthermic perfusion (IPHP). Seventy patients with PMP (31 males and 39 females) were enrolled onto a Phase II clinical trial. One patient was operated on twice because of disease recurrence. CRS was performed with peritonectomy procedures. The closed, opened and semi-closed abdomen techniques were employed for IPHP using cisplatin plus mitomycin-C for 60 minutes under hyperthermic conditions (42.5 degrees C). Sixty two (87%) patients were optimally cytoreduced. Five-year overall survival, progression-free survival and locoregional progression-free survival were 91%, 54% and 69%, respectively. Thirteen Grade III complications occurred in 10 (14%) patients and the most frequent one was gastrointestinal fistula/perforation (11%). There was one case (1.4%) of treatment-related mortality 21 days after treatment. CRS associated with IPHP permitted complete tumour removal with an acceptable morbidity and mortality in patients with PMP. This study confirms the efficacy of the combined treatment on long-term survival and local disease control.
Insights
Cytoreductive surgery (CRS) combined with intraperitoneal hyperthermic perfusion (IPHP) offers improved survival for pseudomyxoma peritonei (PMP) patients. This treatment approach demonstrates efficacy in long-term survival and local disease control for this rare condition.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pseudomyxoma peritonei (PMP) is a rare malignancy with poor outcomes if untreated.
- PMP involves widespread mucin accumulation within the peritoneal cavity.
- Optimal treatment strategies for PMP remain an area of investigation.
Purpose of the Study:
- To evaluate the survival, morbidity, toxicity, and mortality associated with cytoreductive surgery (CRS) and intraperitoneal hyperthermic perfusion (IPHP) in PMP patients.
- To assess the long-term efficacy of CRS + IPHP for PMP management.
Main Methods:
- A multicentric Phase II clinical trial enrolled 70 patients with PMP.
- Cytoreductive surgery (CRS) involved peritonectomy procedures.
- Intraperitoneal hyperthermic perfusion (IPHP) utilized cisplatin and mitomycin-C at 42.5°C for 60 minutes, employing closed, opened, or semi-closed abdomen techniques.
Main Results:
- Eighty-seven percent (62/70) of patients achieved optimal cytoreduction.
- Five-year overall survival, progression-free survival, and locoregional progression-free survival rates were 91%, 54%, and 69%, respectively.
- Grade III complications occurred in 14% of patients, with gastrointestinal fistula/perforation being the most common (11%); treatment-related mortality was 1.4%.
Conclusions:
- CRS combined with IPHP is an effective treatment for PMP, achieving complete tumor removal.
- The combined approach demonstrates acceptable morbidity and mortality rates.
- This treatment strategy confirms efficacy in improving long-term survival and local disease control for PMP.
