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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4807 - Long-term Outcomes with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Peritoneal Carcinomatosis: 10-Year Experience in a Developing Country

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Cytotoxic Therapy;  Surgical Oncology

Tumour Site

Gastrointestinal Cancers

Presenters

Fernando Arias

Citation

Annals of Oncology (2018) 29 (suppl_8): viii150-viii204. 10.1093/annonc/mdy281

Authors

F. Arias1, E. Londoño-Schimmer2, J. Otero3, C.E. Cétares2, G.E. Herrera2, M. Mora2, P. Rodriguez4, M. Mejía4, J.D. Guerra5, A. Ruiz-Patiño6, A.F. Cardona Zorrilla6

Author affiliations

  • 1 Department Of Surgery, Peritoneal Neoplasms Clinical Care Center, Fundacion Santa Fe de Bogota, 110111 - Bogota/CO
  • 2 Department Of Surgery, Peritoneal Neoplasms Clinical Care Center, Fundacion Santa Fe de Bogota, Bogota/CO
  • 3 Clinical Oncology Group, Institute Of Oncology, Fundacion Santa Fe de Bogota, Bogota/CO
  • 4 Department Of Pathology, Fundacion Santa Fe de Bogota, Bogota/CO
  • 5 Facultad De Medicina, Universidad de los Andes, Bogota/CO
  • 6 Translational Research, Foundation for Clinical and Applied Cancer Research, 110231 - Bogotá/CO
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Resources

Abstract 4807

Background

Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a comprehensive treatment of peritoneal malignancies and it is currently a viable option in the increasing number of specialized centers all around the world.

Methods

A review of 119 CRS/HIPEC patients operated between 2007-2017 in a tertiary referral center of Bogotá, Colombia was performed. Patient characteristics, surgical variables, and postoperative outcomes were prospectively collected and analyzed.

Results

Median age at diagnosis was 51-yo (r, 22-78) and 73% (n = 87) were female. Primary origin of the peritoneal carcinomatosis was the appendix in 64%, advanced ovarian and primary peritoneal carcinomas (PC) in 17%, colorectal cancer (CRC) in 10.1%, peritoneal mesothelioma (PM) in 9%, and others in 1.6%. Prior surgical Peritoneal Cancer Index (PCI) was 19 (r, 2-39) and 25.2% were exposed to preoperative chemotherapy. Complete cytoreduction rate (CCR) was 81.5% (75% appendiceal tumors, 94% OC, 83% CRC, and 100% PM [p = 0.81]). Grade III, IV, and V complications were reported in 10%, 12%, and 4% of patients, respectively. Progression-free survival (PFS) was 38.4 months (95%CI 12.6-64.3) and 5-year PFS was 64%. PFS was positively influenced by appendiceal and mesothelioma histology (p = 0.035) as well as complete cytoreduction (p = 0.0001). At 42-month median follow-up 26 patients have died and the median overall survival (OS) was 108.5 months (95%CI 77.5-139.5). OS of patients with t relapse was 78.6 months (95% CI 36.1-121.1) and NR (p = 0.002), respectively, and only this variable adversely affected the multivariate analysis (RR 3.7, 95% CI 1.4-9.5; p = 0.007).

Conclusions

CRS/HIPEC is an effective treatment for patients with PC providing long-term survival and should be considered as standard of care. Our results, from a specialized center in a developing Latin-American country, are comparable to those from first-world centers, implying the importance of group experience in providing high-quality outcomes. Results showed that patients without relapse at the 5th year follow-up could be considered cured, but should always resume observation.

Clinical trial identification

Legal entity responsible for the study

Fundacion Santa Fe de Bogotá.

Funding

Fundacion Santa Fe de Bogotá.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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