Efficacy of Hyperthermic Intraperitoneal Chemotherapy Alone for Diffuse Peritoneal Carcinomatosis from Pancreatic Adenocarcinoma: A Single-Centre Retrospective Cohort Study

Abstract

Abstract Background. Pancreatic ductal adenocarcinoma (PDAC) is associated with poor prognosis, and the median survival of patients with peritoneal carcinomatosis (PC) from PDAC is measured in weeks. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported to improve survival. Although performing CRS is difficult in most patients with advanced PDAC, the role of HIPEC in patients with diffuse PC from PDAC has not yet been defined. This retrospective single-centre study aimed to evaluate the efficacy of sole HIPEC treatment and to identify principal prognostic indicators in patients with PC from PDAC. Method. The HIPEC group included 316 patients with diffuse PC from PDAC who were treated with HIPEC from January 2016 to October 2022. The standard group included pancreatic PC patients treated with intravenous chemotherapy without HIPEC during the same period. Kaplan–Meier survival curves and multivariate Cox regression models were used for analysis. Results. Median age was 63 years. Median follow-up duration was 6.6 months. Positive prognostic indicators included gender, differentiation of pancreatic cancer, chemotherapy before HIPEC, level of leukocyte counts, albumin level, and the level of serum CA19-9. Conclusion. HIPEC is recommended for those patients with diffuse PC from PDAC and acceptable mortality and morbidity. The prognostic role of serum markers and chemotherapy may be important in advanced PDAC with PC.