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Long-Term Survival in Patients Treated by Cytoreductive Surgery with or Without HIPEC for Peritoneal Surface Malignancies—A report from the Indian HIPEC Registry

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Abstract

A previous report from the Indian HIPEC registry showed acceptable early survival and morbidity in patients undergoing cytoreductive surgery (CRS) + / − hyperthermic intraperitoneal chemotherapy (HIPEC). The goal of this retrospective study was to evaluate the long-term outcomes in these patients. Three hundred seventy-four patients treated from December 2010 to December 2016 and enrolled in the Indian HIPEC registry were included. All patients had completed 5 years from the date of surgery. The 1-, 3-, 5- and 7-year progression-free (PFS) and overall survival (OS) and factors affecting these were evaluated. The histology was epithelial ovarian cancer in 209 (46.5%), pseudomyxoma peritonei (PMP) in 65 (17.3%) and colorectal cancer in 46 (12.9%) patients. The peritoneal cancer index (PCI) was ≥ 15 in 160 (42.8%). A completeness of cytoreduction (CC) score of 0/1 resection was obtained in 83% (CC-0–65%; CC-1–18%). HIPEC was performed in 59.2%. At a median, follow-up of 77 months (6–120 months), 243 (64.9%) patients developed recurrence, and 236 (63%) died of any cause; 138 (36.9%) were lost to follow-up. The median OS was 56 months (95% CI 53.42–61.07), and the median PFS was 28 months (95% CI 37.5–44.4). The 1-, 3-, 5- and 7-year OS was 97.6%, 63%, 37.7% and 24% respectively. The 1-, 3-, 5- and 7-year PFS was 84.8%, 36.5%, 27.3% and 22% respectively. The use of HIPEC (p = 0.03) and PMP of appendiceal origin (p = 0.01) was independent predictors of a longer OS. CRS + / − /HIPEC may achieve long-term survival in patients with PM from different primary sites in the Indian scenario. More prospective studies are needed to confirm these findings and identify factors influencing long-term survival.

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  1. Praveen Kammar and Snita Sinukumar contributed equally to this manuscript and are joint first authors.

Authors and Affiliations

  1. Dept. of Surgical Oncology, Jehangir Hospital, Pune, India

    Snita Sinukumar

  2. Dept. of Surgical Oncology, Saifee Hospital, Mumbai, India

    Praveen Kammar & Sanket Mehta

  3. Dept. of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India

    Mukurdipi Ray & Suryanarayan V. S. Deo

  4. Dept. of Surgical Oncology, Zydus Hospital, Thaltej, Ahmedabad, 380054, India

    Sakina Shaikh, Ankita Patel & Aditi Bhatt

  5. Dept. of Surgical Oncology, Kovai Medical Centre, Coimbatore, India

    Firoz Rajan

  6. Dept. of Surgical Oncology, Apollo Hospital, Chennai, India

    Ayyappan Srinivasan & Vikas Mahajan

  7. Dept. of Surgical Oncology, MVR Cancer Centre, Calicut, India

    Dileep Damodaran

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Sinukumar, S., Kammar, P., Ray, M. et al. Long-Term Survival in Patients Treated by Cytoreductive Surgery with or Without HIPEC for Peritoneal Surface Malignancies—A report from the Indian HIPEC Registry. Indian J Surg Oncol 14 (Suppl 1), 198–208 (2023). https://doi.org/10.1007/s13193-023-01727-7

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