75P - Combined cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in women with inadvertently morcellated uterine leiomyosarcoma: A registry study from a tertiary referral hospital

Background

To evaluate the efficacy and safety of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) in patients with inadvertently morcellated uterine leiomyosarcoma (uLMS).

Methods

This was a retrospective cohort study of data obtained from the HIPEC PROGRAM Registry. Patients with occult uLMS who underwent unprotected morcellation were included. Progression-free survival (PFS) and overall survival (OS) were estimated, and treatment-related adverse events (AEs) were analyzed. A Cox proportional hazards regression model was used to assess potential prognostic factors.

Results

Nineteen patients were included, and all patients had FIGO stage I occult uLMS. The median time interval from morcellation to CRS-HIPEC (TM-CRS) was 22 days (range: 11–51 days). Complete resection was achieved in all patients, with malignant peritoneal implants found in 5 patients (26.3%). Following CRS, all patients received HIPEC with a combination of docetaxel (75 mg/m²) and gemcitabine (1000 mg/m²). The median follow-up time was 40 months (range: 9–66 months). The 6-month, 1-year, 2-year, 3-year, and 5-year PFS rates were 94.7%, 89.5%, 84.2%, 84.2%, and 84.2%, respectively. The corresponding OS rates were 100%, 94.7%, 89.2%, 89.2%, and 89.2%, respectively. TM-CRS was the only factor associated with increased recurrence risk. Analysis of the receiver operating characteristic curves revealed an optimal TM-CRS cutoff of 23 days, with patients who underwent CRS-HIPEC within this window having longer PFS times. Only one patient experienced a grade 3 surgical site infection; no other serious AEs were reported.

Conclusions

CRS-HIPEC is a safe and feasible first-line treatment for morcellated uLMS. The survival benefit may be higher for patients who undergo CRS-HIPEC within 23 days after morcellation.

Clinical trial identification

NCT06678763.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.