Abstract
Background Hepatopancreaticobiliary malignancies with peritoneal carcinomatosis (PC) exhibit poor survival with current therapies; HCC 11 months with sorafenib, pancreaticobiliary 9-14 months with systemic chemotherapy. Methods We retrospectively reviewed our institutional hepatopancreaticobiliary malignancies with PC which underwent CRS/HIPEC from 2007-2017 and analyzed perioperative and oncologic outcomes. Results 17 patients were included; 9 HCC, 8 pancreaticobiliary (4 cholangiocarcinoma, 3 gallbladder, 1 pancreatic). PCI (12 vs. 9), completeness of cytoreduction (78% vs. 75%) and 30-day morbidity (11% vs. 13%) were equivalent. HCC received less neoadjuvant therapy (11% vs. 75%, p=0.008), though adjuvant therapy rates were similar (78% vs. 100%, p=0.156). At a median follow-up of 15 months, PFS was similar (7 vs. 10 months p=0.957). However, OS was longer in HCC (42 vs. 15 months p=0.206) with 59% 3-year OS (vs. 0% pancreaticobiliary). Conclusions CRS/HIPEC may offer a survival benefit in select HCC patients with PC, though has dubious utility in PB malignancies.
Perioperative systemic chemotherapy for appendiceal mucinous carcinoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
