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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Urothelial Origin: a Case Report and Literature Review

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Abstract

Introduction

Urothelial carcinomas (UC) are the fourth most common tumours. Approximately, 50% of patients with invasive bladder cancer relapse after radical cistectomy (RC). In this report, we present the case of peritoneal carcinomatosis from bladder UC treated with cytoreductive surgery plus the administration of hyperthermic intraperitoneal chemotherapy (CRS + HIPEC).

Case Presentation

A 34-year-old woman diagnosed with high-grade bladder cancer with peritoneal recurrence in 2017. She underwent cytoreductive surgery followed by HIPEC with mitomycin C. Histopathological results showed metastases from UC in the left ovary and right diaphragmatic peritoneum. In 2021, the patient underwent surgery after treatment with atezolizumab for abdominal wall recurrence. Today, the patient is alive and free of tumor recurrence 12 months after the last surgery.

Discussion

Despite advances in surgical technique and patient selection, the risk of relapse remains high among patients with muscle-invasive bladder cancer. We face the case of a young female patient with local, peritoneal, and lymphatic recurrence of bladder cancer after RC who had a partial response to chemotherapy. The possibility of CRS + HIPEC is offered by the surgical oncology unit, referent in the management of peritoneal carcinomatosis. Surgery is capable of resecting residual tumor in patients with a partial response or who have been erroneously underdiagnosed.

Conclusion

CRS + HIPEC might be a valid option to be considered in well-selected patients and to be performed in reference units. There is a need for more collaborative clinical trials and prospective studies addressing the role of surgery in patients with metastatic bladder cancer.

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Authors and Affiliations

  1. Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain

    Blanca Rufián-Andújar, Francisca Valenzuela-Molina, Lidia Rodríguez-Ortiz, Sebastián Rufián-Peña, Francisco Javier Briceño-Delgado & Álvaro Arjona-Sánchez

  2. GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical, Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain

    Blanca Rufián-Andújar, Francisca Valenzuela-Molina, Lidia Rodríguez-Ortiz, Sebastián Rufián-Peña & Álvaro Arjona-Sánchez

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  1. Blanca Rufián-Andújar
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  2. Francisca Valenzuela-Molina
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  3. Lidia Rodríguez-Ortiz
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  4. Sebastián Rufián-Peña
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  5. Francisco Javier Briceño-Delgado
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  6. Álvaro Arjona-Sánchez
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Contributions

Study design: Blanca Rufián Andújar and Francisca Valenzuela-Molina. Manuscript writing: Blanca Rufián Andújar and Álvaro Arjona-Sánchez. Data acquisition (surgeons): Lidia Rodríguez-Ortiz and Álvaro Arjona-Sánchez. Critical revision: Álvaro Arjona Sánchez and Sebastián Rufián Peña; Francisco Javier Briceño Delgado. The authors read and approved the final manuscript.

Corresponding author

Correspondence to Álvaro Arjona-Sánchez.

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The authors declare that they have no conflict of interest.

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The patient provided signed consent for the surgery alongside with accepting that her case may be used for educational and scientific purposes.

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Rufián-Andújar, B., Valenzuela-Molina, F., Rodríguez-Ortiz, L. et al. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Urothelial Origin: a Case Report and Literature Review. Indian J Surg Oncol 14 (Suppl 1), 106–108 (2023). https://doi.org/10.1007/s13193-022-01616-5

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