Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies?
Abstract Background Hepatopancreaticobiliary malignancies with peritoneal carcinomatosis exhibit poor survival with current therapies: hepatocellular carcinoma 11 months with sorafenib, and pancreaticobiliary 9–14 months with systemic chemotherapy. However, limited data exist on the utility of cytor...
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doaj-d0ea82764f954149b5bf3a861eeb3c852020-11-25T03:26:04ZengBMCWorld Journal of Surgical Oncology1477-78192020-06-011811810.1186/s12957-020-01898-5Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies?Natasha Leigh0Daniel Solomon1Eric Pletcher2Daniel M. Labow3Deepa R. Magge4Umut Sarpel5Benjamin J. Golas6Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalDivision of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalDivision of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalDivision of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalDivision of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalDivision of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalDivision of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke’s West HospitalAbstract Background Hepatopancreaticobiliary malignancies with peritoneal carcinomatosis exhibit poor survival with current therapies: hepatocellular carcinoma 11 months with sorafenib, and pancreaticobiliary 9–14 months with systemic chemotherapy. However, limited data exist on the utility of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in these patients. Methods We retrospectively reviewed our institutional hepatopancreaticobiliary malignancies with peritoneal carcinomatosis which underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy from 2007 to 2017 and analyzed perioperative and oncologic outcomes. Results Seventeen patients were included: 9 hepatocellular carcinoma, 8 pancreaticobiliary (4 cholangiocarcinoma, 3 gallbladder, 1 pancreatic). Peritoneal cancer index, number of organs resected, completeness of cytoreduction, and 30-day morbidity were equivalent. Hepatocellular carcinoma received significantly less neoadjuvant therapy (11%, p = 0.008), though adjuvant therapy rates were similar. At a median follow-up of 15 months, progression-free survival was similar amongst all cohorts. However, overall survival was longer in hepatocellular carcinoma (42 months vs. cholangiocarcinoma 19 months, gallbladder 8 months, pancreatic 15 months, p = 0.206) with 59% 3-year overall survival (vs. 0% cholangiocarcinoma, 0% gallbladder, 0% pancreatic). Conclusions Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy may offer a survival benefit in select hepatocellular carcinoma patients with peritoneal carcinomatosis, though has dubious utility in pancreaticobiliary malignancies.http://link.springer.com/article/10.1186/s12957-020-01898-5Peritoneal carcinomatosisHyperthermic intraperitoneal chemotherapyCytoreductive surgeryHepatocellular carcinomaHepatobiliary malignancy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Natasha Leigh Daniel Solomon Eric Pletcher Daniel M. Labow Deepa R. Magge Umut Sarpel Benjamin J. Golas |
spellingShingle |
Natasha Leigh Daniel Solomon Eric Pletcher Daniel M. Labow Deepa R. Magge Umut Sarpel Benjamin J. Golas Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? World Journal of Surgical Oncology Peritoneal carcinomatosis Hyperthermic intraperitoneal chemotherapy Cytoreductive surgery Hepatocellular carcinoma Hepatobiliary malignancy |
author_facet |
Natasha Leigh Daniel Solomon Eric Pletcher Daniel M. Labow Deepa R. Magge Umut Sarpel Benjamin J. Golas |
author_sort |
Natasha Leigh |
title |
Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? |
title_short |
Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? |
title_full |
Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? |
title_fullStr |
Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? |
title_full_unstemmed |
Is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? |
title_sort |
is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy indicated in hepatobiliary malignancies? |
publisher |
BMC |
series |
World Journal of Surgical Oncology |
issn |
1477-7819 |
publishDate |
2020-06-01 |
description |
Abstract Background Hepatopancreaticobiliary malignancies with peritoneal carcinomatosis exhibit poor survival with current therapies: hepatocellular carcinoma 11 months with sorafenib, and pancreaticobiliary 9–14 months with systemic chemotherapy. However, limited data exist on the utility of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in these patients. Methods We retrospectively reviewed our institutional hepatopancreaticobiliary malignancies with peritoneal carcinomatosis which underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy from 2007 to 2017 and analyzed perioperative and oncologic outcomes. Results Seventeen patients were included: 9 hepatocellular carcinoma, 8 pancreaticobiliary (4 cholangiocarcinoma, 3 gallbladder, 1 pancreatic). Peritoneal cancer index, number of organs resected, completeness of cytoreduction, and 30-day morbidity were equivalent. Hepatocellular carcinoma received significantly less neoadjuvant therapy (11%, p = 0.008), though adjuvant therapy rates were similar. At a median follow-up of 15 months, progression-free survival was similar amongst all cohorts. However, overall survival was longer in hepatocellular carcinoma (42 months vs. cholangiocarcinoma 19 months, gallbladder 8 months, pancreatic 15 months, p = 0.206) with 59% 3-year overall survival (vs. 0% cholangiocarcinoma, 0% gallbladder, 0% pancreatic). Conclusions Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy may offer a survival benefit in select hepatocellular carcinoma patients with peritoneal carcinomatosis, though has dubious utility in pancreaticobiliary malignancies. |
topic |
Peritoneal carcinomatosis Hyperthermic intraperitoneal chemotherapy Cytoreductive surgery Hepatocellular carcinoma Hepatobiliary malignancy |
url |
http://link.springer.com/article/10.1186/s12957-020-01898-5 |
work_keys_str_mv |
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