Locoregional Treatment of Peritoneal Sarcomatosis. A single-centre experience

Abstract

BACKGROUND: Peritoneal sarcomatosis appears to be responding poorly to systemic chemotherapy. Treatment options traditionally include surgical ressections, chemotherapy and radiation therapy. Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) offers a promising alternative locoregional treatment option.

PATIENTS AND METHODS: We examine retrospectively 8 patients (4 females, 4 males) with peritoneal sarcomatosis. The most common histology type was the liposarcoma (4/8). The chemotherapeutic agents that were administered were mitomycin, cisplatin and doxorubicin. We analyse our cases with regard to the PCI, the CC score, the complications that occurred and the overall survival.

RESULTS: A complete level of cytoreduction (CC0/1) was feasible in 5/8 of patients. We report post-operative complications such as GI leaks and fistulas in 3 cases and infections in 2 cases. Overall survival was proved to depend on the PCI (better overall survival rate when PCI<20) DISCUSSION: We identify acceptable morbidity, comparable to other series of patients undergoing CRS+HIPEC for other histologies. The specific sarcoma type and the previous treatment received prove to be factors that alter significantly the prognosis and the survival rates: therefore, conclusions cannot be safely excluded in such small patient series. On the whole, we conclude that, given the already positive and promising results from CRS+HIPEC in sarcomatosis, more studies need to be performed, in order to determine the role of all the aforementioned factors.