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Outcome and Safety of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) +/- Intraoperative Radiation Therapy (IORT) in the Management of Peritoneal

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Last updated: 01 Jan 2025

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Abstract

Background: Peritoneal sarcomatosis (PS) is an aggressive disease; cytoreductive surgery (CRS) could be curative.
Aim: Can the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) +/- intraoperative radiation therapy (IORT) overcome treatment failure with an overall survival benefit.
Methods: Retrospective review of the medical records of patients with PS treated by CRS, HIPEC and IORT at a comprehensive cancer center in the period between 2011-2016.
Results: Twenty-four patients were identified. Fifteen were men and their median age was 58 years. Liposarcoma was the most frequent diagnosis (50%). Cytoreduction completeness (CC) score 0/1 was achieved in 19 patients, with a median pathological peritoneal cancer index (pPCI) of 12. Intraoperative radiation therapy was given in 16 patients. Eight patients developed grade III-IV Clavien-Dindo post-operative complications and 1 patient died 5 days post operative. Adjuvant chemotherapy was received in 9 patients. After a median follow-up of 28.5 months, the median PFS was 20.7 months, while the estimated 2- and 4-year PFS were 37.1% and 19.1%, respectively. The median OS was 176.5 months and the estimated 2- and 4-year OS were 95.8% and 79.8%, respectively. In the univariate analysis, the PFS differed significantly according to the CC score only. The median PFS for patients with CC 0-1 was 23.8 vs. 8.8 months for those with CC 2-3 (p = 0.027).
Conclusions: The addition of HIPEC and IORT to CRS in the management of PS is feasible and safe. Comparing our results to several studies, this multimodality approach seems to improve local and regional control rates. A larger cohort of patients is needed for further evaluation and to give a concrete conclusion.

DOI

10.21608/resoncol.2021.99181.1153

Keywords

Peritoneal sarcomatosis, Cytoreductive Surgery, Hyperthermic intraperitoneal chemotherapy, Intraoperative radiation therapy

Authors

First Name

Ahmed

Last Name

Elashwah

MiddleName

-

Affiliation

Radiation Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia , Kasr Al-Aini Center for Clinical Oncology and Nuclear Medicine (NEMROCK), Faculty of Medicine, Cairo University, Cairo, Egypt

Email

ashwah_a80@yahoo.com

City

-

Orcid

-

First Name

Ahmed

Last Name

Badran

MiddleName

-

Affiliation

Medical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia , Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Email

doctorbadran@med.asu.edu.eg

City

-

Orcid

0000-0001-9994-8878

First Name

Mahmoud

Last Name

Elshenawy

MiddleName

A.

Affiliation

Medical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia , Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt

Email

mahmoudelshenawy78@gmail.com

City

-

Orcid

0000-0002-2463-3342

First Name

Ayman

Last Name

Azzam

MiddleName

-

Affiliation

Surgical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia , General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

Email

aazzam70@yahoo.com

City

-

Orcid

-

First Name

Rania

Last Name

Naguib

MiddleName

-

Affiliation

Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt , Clinical Science Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

Email

ranianaguib2000@yahoo.com

City

-

Orcid

-

First Name

Aisha

Last Name

Alshibani

MiddleName

-

Affiliation

Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Email

aalshibani3@kfshrc.edu.sa

City

-

Orcid

-

First Name

Reem

Last Name

Alrakaf

MiddleName

-

Affiliation

Surgical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Email

ralrakaf@kfshrc.edu.sa

City

-

Orcid

-

First Name

Abdelmoniem

Last Name

Eldali

MiddleName

-

Affiliation

Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Email

aeldali@hotmail.com

City

-

Orcid

-

First Name

Tarek

Last Name

Amin

MiddleName

-

Affiliation

Surgical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Email

tamin@kfshrc.edu.sa

City

-

Orcid

-

Volume

18

Article Issue

1

Related Issue

35384

Issue Date

2022-06-01

Receive Date

2021-10-02

Publish Date

2022-06-01

Page Start

19

Page End

28

Print ISSN

2357-0687

Online ISSN

2357-0695

Article File

RESONCOL_Volume 18_Issue 1_Pages 19-28.pdf

PDF . 246.3kB

Link

https://resoncol.journals.ekb.eg/article_218734.html

Detail API

https://resoncol.journals.ekb.eg/service?article_code=218734

Order

3

Type

Original Article

Type Code

200

Publication Type

Journal

Publication Title

Research in Oncology

Publication Link

https://resoncol.journals.ekb.eg/

MainTitle

Outcome and Safety of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) +/- Intraoperative Radiation Therapy (IORT) in the Management of Peritoneal Sarcomatosis: A Real-World Experience

Details

Type

Article

Created At

22 Jan 2023