Maximal peritonectomy plus intraperitoneal chemo-hyperthermia (IPCH) in patients with peritoneal carcinomatosis. A single institution experience.

5168 Background: For most patients (pts), peritoneal carcinomatosis has an ominous prognosis and chemotherapy gives some responses without impact in survival. Recently, extensive peritonectomy plus IPCH has shown promising results with 5-year disease free survival up to 25%.,At our institution, peritonectomy is followed by dextrose 1.5% peritoneal perfusion (open wall) at 0.5-1 l/min perfusion rate extracorporally heated to maintain peritoneal surfaces at 43-44 °C for 90 minutes. Dextrose is admixed with a chemotherapeutic drug (Paclitaxel 60mg/m2 or Mitomycin 10-12.5mg/m2 or Oxaliplatin 460mg/m2, depending on the tumor type). Additional resections are performed if requiered.,From June/01 to Oct/04, 33 pts with a median age of 57 years (range 23 to 75 years) have been treated. Sixteen pts had ovarian cancer, 13 pts colorectal cancer, 2 pts gastric cancer and 2 pts endometrial cancer. Almost all pts had been treated previously with surgery and chemotherapy. Median Peritoneal Cancer Index has been 3 (range 0 to 24). A complete resection has been achieved in 31 pts while 3 pts had a incomplete resection. Six patients experienced a prolonged paralytic ileus, abdominal wall abscess 2 pts, urinary tract infection 2 pts, abdominal hemorrage 1 pt and transient renal damage 1 pt. Three pts had severe neutropenia, 2 pts died of sepsis (one in the context of neutropenia and other pt due to anastomotic fistulae). Currently, 15 pts are alive and free of disease, 5 of them after salvage surgery in the thorax (2 pts), abdomen (1 pt) and pelvis (1 pt). Eight pts are living longer than 2 years. Median PFS is 8 months (range 2-37+). MOS has not been achieved with a 63% actuarial 3-year survival.,Peritonectomy plus IPCH is a feasible technique that could render a benefit in survival and a chance for cure in carefully selected patients who otherwise have not an alternative option. The program is currently active and new pts are being included. No significant financial relationships to disclose.