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Hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies: A single institution Indian experience
S P Somashekhar1, G Prasanna2, Rajshekhar Jaka2
1Department of Surgical Oncology and Robotic Surgery, Manipal Comprehensive Cancer Center, Manipal Hospital, 98 HAL Airport Road, Bengaluru 560017, Karnataka, India.
The National Medical Journal of India
|January 19, 2017
Summary
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is feasible for Indian patients with peritoneal surface malignancies (PSM). This approach shows promising oncological outcomes with low mortality and acceptable morbidity.
Area of Science:
- Surgical Oncology
- Medical Oncology
- Gastroenterology
Background:
- Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) offers improved oncological outcomes for peritoneal surface malignancies (PSM).
- Assessing the feasibility and perioperative results of CRS + HIPEC in Indian patients is crucial for wider adoption.
Purpose of the Study:
- To evaluate the feasibility and perioperative outcomes of cytoreductive surgery followed by HIPEC in Indian patients with PSM.
- To analyze short-term oncological outcomes and complications associated with this combined treatment modality.
Main Methods:
- A prospective observational study included 56 patients with PSM undergoing CRS + HIPEC.
- HIPEC was administered at 42°C for 30-90 minutes, with chemotherapy tailored to the primary malignancy.
- Perioperative outcomes, complications, and short-term oncological results were collected and analyzed.
Main Results:
- The study included patients with ovarian, colorectal, and other PSMs. Median surgery duration was 9 hours, with a median hospital stay of 12 days.
- Common grade 3/4 complications included hypocalcemia and hypokalemia. Major morbidity occurred in 8.9% of patients, with a 60-day operative mortality of 1.8%.
- At a median follow-up of 16 months, recurrence rates were 7.1% for peritoneal and 8.9% for systemic disease. Overall mortality was 7.1%.
Conclusions:
- Cytoreductive surgery and HIPEC are feasible and demonstrate potential benefits for Indian patients with PSM.
- The procedure can be performed with low mortality and acceptable morbidity, provided a dedicated multidisciplinary team and adequate infrastructure are available.
