Iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent peritoneal metastases

Abstract Background: Our aim was to analyze the safety and efficacy of iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (iCRS-HIPEC) in patients with peritoneal recurrence from different tumor types. Patients and Methods: Data on indications, intraoperative findings and postoperative outcome of all patients treated with iCRS-HIPEC at our Institution were reviewed. Results: Between 2010-2018, 10 iCRS-HIPEC procedures for peritoneal recurrence in eight patients were performed. The median peritoneal cancer index was 14.5 (range=2-33). Completeness of cytoreduction was CC0-1 in most cases (9/10). Three grade III-IV complications (two intestinal fistulas, one bleeding) were recorded and there was no operative mortality. After a median follow-up of 19.5 months, six patients experienced recurrence after a median of 12.5 months. Conclusion: iCRS-HIPEC is a safe procedure in selected patients with recurrent peritoneal surface malignancies. Selection criteria still remain questionable and need to be further evaluated in large cooperative multi-institution studies.