Management of peritoneal carcinomatosis from appendiceal mucinous adenocarcinoma by cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: Experience on 48 patients from a single center

Abstract

Abstract Purpose To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of patients with peritoneal carcinomatosis (PC) from appendiceal mucinous adenocarcinoma.Methods The clinical data of 48 cases of PC with mucinous appendiceal adenocarcinoma treated with CRS + HIPEC were retrospectively analyzed. The study indices included survival, perioperative safety, and adverse reactions.Results The peritoneal cancer index (PCI) score ranged from 1 to 39 in the 48 patients with peritoneal cancer of appendix adenocarcinoma, with a median score of 21. The degree of tumor reduction (CC) was 0 to 3, with a median score of 2. The follow-up period ranged from 16 to 44 months. Of the 48 patients, 18 patients (37.5%) died and 30 patients (62.5%) survived. The median survival time was 37 months (95% CI: 26.0-47.9 months). The 1-, 2-, and 3-year survival rates were 78.0%, 60.9%, and 51.4%. The 1-, 2-, and 3-year survival rates in patients with PCI ≥ 20 were 63.6%, 43.8%, and 32.8%, respectively, while the patients with PCI < 20 had rates of 95%, 81.8%, and 72.7% (P = 0.0139). The 1-, 2-, and 3-year survival rates were 64.4%, 40.9%, and 40.9% in patients with CC > 1, and 95%, 88.2%, and 69.4% in patients with CC ≤ 1 (P = 0.004). The incidence of perioperative adverse events was 8.3%, including 3 cases of incision infection and 1 case of intestinal anastomotic fistula.Conclusion CRS + HIPEC is feasible and effective in the treatment of patients with peritoneal carcinoma from appendiceal mucinous adenocarcinoma.