Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for the treatment of primary peritoneal serous carcinoma: Results of a Chinese retrospective study

Abstract

Purpose Primary peritoneal serous carcinoma (PPSC) is a rare condition with a poor survival rate, even after treatment with debulking surgery followed by systemic chemotherapy. This study evaluated the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of PPSC.

Patients and methods This retrospective study included 22 female patients with primary advanced PPSC (group A, n = 12) or recurrent PPSC (group B, n = 10) treated with 25 CRS + HIPEC procedures. The primary end point was overall survival (OS), and the secondary end points were safety profiles.

Results A total of 25 CRS + HIPEC procedures were performed in these 22 patients. The median OS was 31.0 months (95% confidence interval (CI) 22.3–39.7), and the 1-, 3-, and 5-year survival rates were 100%, 45.5%, and 27.3%, respectively. Subgroup analyses revealed that the median OS was 31.0 months (95% CI 19.8–42.2) for group A vs. 38.5 months (95% CI 9.6–67.4) for group B (P = 0.832, log rank test); 51.5 months (95% CI 34.9–68.1) for peritoneal cancer index (PCI) ≤ 15 vs. 20.3 months (95% CI 12.6–28.0) for PCI > 15 (P = 0.000, log rank test); and 38.5 months (95% CI 22.5–54.5) for completeness of cytoreduction (CC) of 0–1 vs. 23.5 months (95% CI 15.3–31.7) for CC of 2–3 (P = 0.178, log rank test). There were no perioperative deaths. Serious adverse events (SAEs) occurred in two patients (9.1%). A univariate analysis identified PCI ≤ 15 as the only prognostic predicator (hazard ratio (HR) 13.1, 95% CI 2.7–63.4, P = 0.001).

Conclusions CRS + HIPEC could contribute to favourable outcomes for select PPSC patients with acceptable safety profiles.

Keywords:

• Cytoreductive surgery
• hyperthermic intraperitoneal chemotherapy
• primary peritoneal serous carcinoma

Disclosure statement

This work was supported by grants for Hubei Province’s Outstanding Medical Academic Leader Program and the Science Fund for Doctorate Mentors by China’s Ministry of Education (No. 20120141110042). The authors declare no conflicts of interest in this work. The authors alone are responsible for the content and writing of the paper.