Hyperthermic Intraperitoneal Intraoperative Chemotherapy after Cytoreductive Surgery for the Treatment of Abdominal Sarcomatosis: Clinical Outcome and Prognostic Factors in 60 Consecutive Patients

Carlo Riccardo Rossi, Marcello Deraco, Michele De Simone, Simone Mocellin, Pierluigi Pilati, Mirto Foletto, Francesco Cavaliere, Shigeki Kusamura, Alessandro Gronchi, Mario Lise

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. Abdominal sarcomatosis is a rare nosologic entity with a poor prognosis. After a Phase I study on cytoreductive surgery combined with hyperthermic intraperitoneal intraoperative chemotherapy (HIIC), the authors reported the results of the treatment of 60 patients using this novel multimodal approach. METHODS. Twenty-nine patients had multifocal primary disease and 31 patients had recurrent abdominal sarcoma. Tumor histology was represented by visceral (n = 26 [43%]) and retroperitoneal (n = 34 [57%]) sarcoma. All patients underwent cytoreductive surgery (with no or minimal residual disease) and 90-minute HIIC with doxorubicin (15.25 mg/L of perfusate) and cisplatin (43 mg/L). The clinical outcome and the prognostic value of 11 clinicopathologic variables were analyzed. RESULTS. No postoperative deaths occurred. The morbidity rate was 33% and the moderate to severe locoregional toxicity rate was 15%. The median time to local disease progression and the median overall survival were 22 months and 34 months, respectively. Using multivariate analysis, histologic grading and completeness of surgical cytoreduction predicted patient prognosis, indicating that both local progression-free and overall survival were affected significantly by tumor aggressiveness and local disease control. CONCLUSIONS. Although these results were encouraging, there was no definitive conclusion reached regarding the therapeutic activity of this locoregional treatment. In addition, the toxicity rate was substantial. In the absence of effective systemic agents, the therapeutic potential of cytoreductive surgery plus HIIC should be explored further in comparative trials.

Original languageEnglish
Pages (from-to)1943-1950
Number of pages8
JournalCancer
Volume100
Issue number9
DOIs
Publication statusPublished - May 1 2004

Keywords

  • Abdominal sarcomatosis
  • Cytoreductive surgery
  • Hyperthermic intraperitoneal intraoperative chemotherapy (HICC)
  • Poor prognosis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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