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Article

The impact of HIPEC vs. EPIC for the treatment of mucinous appendiceal carcinoma: a study from the US HIPEC collaborative

Jennifer L. Leitinga Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA

https://orcid.org/0000-0002-5784-7937

Courtney N. Dayb Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

William S. Harmsenb Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

Jordan M. Cloydc Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

Sherif Abdel-Misihc Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

Keith Fournierd Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

Andrew J. Leed Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

Sean Dineene Department of Gastrointestinal Oncology, Moffitt Cancer Center, Morsani College of Medicine, Tampa, FL, USA

Sophie Dessureaulte Department of Gastrointestinal Oncology, Moffitt Cancer Center, Morsani College of Medicine, Tampa, FL, USA

Jula Veeraponghf Department of Surgery, Division of Surgical Oncology, University of California, San Diego, CA, USA

Joel M. Baumgartnerf Department of Surgery, Division of Surgical Oncology, University of California, San Diego, CA, USA

Callisia Clarkeg Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

Harveshp Mogalg Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

Maria C. Russellh Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA

Mohammad Y. Zaidih Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA

Sameer H. Pateli Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Mackenzie C. Morrisi Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Ryan J. Hendrixj Department of Surgery, Division of Surgical Oncology, University of Massachusetts Medical School, Worcester, MA, USA

Laura A. Lambertk Peritoneal Surface Malignancy Program Section of Surgical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

Daniel E. Abbottl Department of Surgery, Division of Surgical Oncology, University of Wisconsin, Madison, WI, USA

Courtney Pokrzywal Department of Surgery, Division of Surgical Oncology, University of Wisconsin, Madison, WI, USA

Mustafa Raoofm Department of Surgery, Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA

Oliver Engm Department of Surgery, Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA

https://orcid.org/0000-0003-0226-5005

Fabian M. Johnstonn Department of Surgery, Johns Hopkins University, Baltimore, MD, USA

Jonathan Greern Department of Surgery, Johns Hopkins University, Baltimore, MD, USA

Travis E. Grotza Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USACorrespondence[email protected]

https://orcid.org/0000-0002-7753-097X

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Abstract

Introduction

Mucinous appendiceal carcinoma is a rare malignancy that commonly spreads to the peritoneum leading to peritoneal metastases. Complete cytoreduction with perioperative intraperitoneal chemotherapy (PIC) is the mainstay of treatment, administered as either hyperthermic intra peritoneal chemotherapy (HIPEC) or early post-operative intraperitoneal chemotherapy (EPIC). Our goal was to assess the perioperative and long term survival outcomes associated with these two PIC methods.

Materials and methods

Patients with mucinous appendiceal carcinoma were identified in the US HIPEC Collaborative database from 12 academic institutions. Patient demographics, clinical characteristics, and survival outcomes were compared among patients who underwent HIPEC vs. EPIC with inverse probability weighting (IPW) used for adjustment.

Results

Among 921 patients with mucinous appendiceal carcinoma, 9% underwent EPIC while 91% underwent HIPEC. There was no difference in Grade III–V complications between the two groups (18.5% for HIPEC vs. 15.0% for EPIC, p=.43) though patients who underwent HIPEC had higher rates of readmissions (21.2% vs. 8.8%, p<.01). Additionally, PIC method was not an independent predictor for overall survival (OS) or recurrence-free survival (RFS) after adjustment on multivariable analysis.

Conclusions

Among patients with mucinous appendiceal carcinoma, both EPIC and HIPEC appear to be associated with similar perioperative and long-term outcomes.

Keywords:

Acknowledgments

This work was presented at the 2019 International Symposium on Regional Cancer Therapies in Phoenix, AZ.

Disclosure statement

The authors have no financial disclosures or conflict of interest. This work has not been previously or concurrently been submitted for publication.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

The impact of HIPEC vs. EPIC for the treatment of mucinous appendiceal carcinoma: a study from the US HIPEC collaborative

Introduction

Materials and methods

Results

Conclusions

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The impact of HIPEC vs. EPIC for the treatment of mucinous appendiceal carcinoma: a study from the US HIPEC collaborative

Abstract

Introduction

Materials and methods

Results

Conclusions

Acknowledgments

Disclosure statement

Data availability

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