Complete cytoreductive surgery plus HIPEC for peritoneal metastases from unusual cancer sites of origin: results from a worldwide analysis issue of the Peritoneal Surface Oncology Group International (PSOGI)

Figures & data

Figure 1. Overall survival according to the PCI in patients who underwent cytoreductive surgery plus HIPEC for peritoneal metastases from rare cancer sites of origin.

Figure 2. Overall survival according to the origin of PM in patients who underwent cytoreductive surgery plus HIPEC for peritoneal metastases from ovarian carcinoma, neuroendocrine tumours and sarcoma.

Table 1. Univariate analysis for overall survival.

Variables	N (%)	Hazard ratio (95%CI)	p value
Gender
Female	516 (70.3)	1.00	0.0018
Male	218 (29.7)	1.43 (1.14–1.79)
Preoperative chemotherapy		37 (.)	<0.0001
No	332 (47.6)	1.00
Yes	365 (52.4)	1.69 (1.35–2.12)
Previous HIPEC		52 (.)	0.3405
No	668 (97.9)	1.00
Yes	14 (2.1)	0.65 (0.27–1.57)
Etiology
Breast cancer	17 (2.3)	2.26 (1.01–5.05)	<0.0001
Cervix	14 (1.9)	2.12 (0.88–5.11)
Cholangiocarcinoma	39 (5.3)	2.85 (1.45–5.6)
Desmoplastic small-round-cell tumour	34 (4.6)	2.29 (1.13–4.65)
Endometre	20 (2.7)	2.11 (0.98–4.56)
GIST	47 (6.4)	1.43 (0.72–2.84)
Hepatocellular carcinoma	19 (2.6)	0.77 (0.29–2.03)
Neuroendocrine tumours	114 (15.5)	1.41 (0.77–2.58)
Pancreas	30 (4.1)	3.23 (1.61–6.45)
Rare ovarian cancer	199 (27.1)	0.82 (0.45–1.49)
Sarcoma	166 (22.6)	1.81 (1.01–3.25)
Urachus	35 (4.8)	1.00
PCI	187 (.)		0.0037
0–9	206 (37.7)	1.00
> =10–14	124 (22.7)	1.26 (0.89–1.78)
> =15	217 (39.7)	1.66 (1.23–2.24)
Residual tumour CC	24 (.)		<0.0001
CC-0 (no residual nodules)	506 (71.3)	1.00
CC-1 (residual <2.5 mm)	128 (18)	1.64 (1.24–2.16)
CC-2 (2.5 mm < residual <2.5 cm)	59 (8.3)	3.08 (2.23–4.25)
CC-3 (residual >2.5 cm)	17 (2.4)	5.3 (3.12–9.02)
Duration of surgery	194 (.)		0.0968
≤8 h	317 (58.7)	1.00
>8 h	223 (41.3)	1.23 (0.96–1.58)
HIPEC Technique	29 (.)		0.0004
Closed abdomen	312 (44.3)	1.49 (1.2–1.85)
Coliseum or open	393 (55.7)	1.00
Duration of HIPEC (min)	24 (.)		<0.0001
≤60 min	264 (37.2)	1.00
>60 min	446 (62.8)	1.63 (1.28–2.08)
Nb of chemo agents for HIPEC	3 (.)		0.8281
1	441 (60.3)	1.02 (0.82–1.28)
2	290 (39.7)	1.00
Type of agents used for HIPEC
Cisplatin	12 (.)		0.2250
No	393 (54.4)	1.00
Yes	329 (45.6)	1.14 (0.92–1.42)
Doxorubicin	16 (.)		0.8044
No	584 (81.3)	1.00
Yes	134 (18.7)	1.04 (0.78–1.38)
Mitomycin C	16 (.)		0.0032
No	399 (55.6)	1.00
Yes	319 (44.4)	1.39 (1.12–1.72)
Irinotecan	16 (.)		0.0046
No	685 (95.4)	1.00
Yes	33 (4.6)	0.36 (0.18–0.73)
Oxaliplatin	14 (.)		0.0004
No	590 (81.9)	1.00
Yes	130 (18.1)	0.56 (0.4–0.77)
Cisplatin + Doxorubicin	16 (.)		0.8426
No	605 (84.3)	1.00
Yes	113 (15.7)	1.03 (0.76–1.4)
Cisplatin + Mitomycin C	16 (.)		0.0657
No	636 (88.6)	1.00
Yes	82 (11.4)	1.33 (0.98–1.8)
Lymph node involvement	133 (.)		<0.0001
No	449 (74.7)	1.00
Yes	152 (25.3)	1.98 (1.53–2.56)
Differentiation (if applicable)	418 (.)		0.0004
Moderately differentiated	77 (24.4)	2.07 (1.34–3.2)
Poorly differentiated	122 (38.6)	2.27 (1.53–3.36)
Undifferentiated	13 (4.1)	2.49 (1.05–5.9)
Well differentiated	104 (32.9)	1.00
Postoperative chemotherapy	181 (.)		0.0014
No	362 (65.5)	1.00
Yes	191 (34.5)	1.54 (1.18–2.01)

Figure 3. Overall and disease-free survival after cytoreductive surgery and HIPEC for rare indications.

Figure 4. Disease-free survival according to the origin of PM in patients who underwent cytoreductive surgery plus HIPEC for peritoneal metastases from ovarian carcinoma, neuroendocrine tumours and sarcoma.