By analysing 20 years of cytoreductive surgery and HIPEC data they have demonstrated that outcomes have clearly improved for patients undergoing this treatment technique according to lead author, Edward Levine.
Cytoreductive surgery, or debulking, is removal of part of a malignant tumor which can't be completely excised and is done to enhance chemotherapy effectiveness. HIPEC is a perfusion technique in which heated chemotherapy is administered directly into the abdomen during the surgery to kill remaining cancer cells.
"Peritoneal dissemination of abdominal malignancy has a clinical course marked by bowel obstruction and death," Levine said. "It traditionally does not respond well to intravenous chemotherapy. This two-phase approach has clearly extended the lives of many of our patients."
For the study, Levine and colleagues reviewed data of 1,000 patients who underwent 1,095 HIPEC procedures over the past two decades. The average age of patients was almost 53 years with slightly more than half being female. Primary tumor sites were: appendix 472(47.2 percent), colorectal 248(24.8 percent), mesothelioma 72(7.2 percent), ovary 69(6.9 percent), gastric 46(4.6 percent), others 97(9.7 percent).
Levine said the median overall survival was 29.9 months, with a five-year survival of 32.5 percent. "The data further shows that patients with advanced abdominal cancer should no longer be approached with therapeutic nihilism," he said. "Long-term survival is clearly possible for selected patients treated with HIPEC."
Levine et. al., (2014). Intraperitoneal chemotherapy for peritoneal surface malignancy: Experience with 1,000 patients. J. Am. Coll. Surg., 218, 573–585 [Abstract]