Improved prognosis following peritonectomy procedures and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from appendiceal carcinoma

Aims: The prognosis of patients with peritoneal carcinomatosis from gastroi ntestinal malignancies is poor. The aim of this study was to analyse the re sults of multimodality treatment for peritoneal carcinomatosis of appendice al carcinoma. Patients and methods: From 07/95 to 01/00, 17 patients (13 males, 4 female, median age 58 years) underwent peritonectomy procedures in combination wit h intraperitoneal hyperthermic chemotherapy. Surgical, pathological and sur vival data were analysed retrospectively. Results: All patients had undergone previous surgical treatment and one pat ient had received chemotherapy. In all patients peritonectomy procedures, a s described by Sugarbaker, were performed with the aim of achieving a macro scopically complete cytoreduction (range 2-6, median 4 procedures per patie nt). Following resection, open hyperthermic intraperitoneal chemotherapy wi th cisplatin was performed. Eleven patients had postoperative complications (predominantly "non-surgical") and two patients died postoperatively. The 4-year survival rate was 75%. Complete cytoreducion had a statistically sig nificant positive influence on long-term survival. Conclusions: In selected patients (WHO status 0/1, minimal residual disease , no distant metastases, complete cytoreduction), the prognosis for patient s with peritoneal carcinomatosis of appendiceal origin can be improved by p eritonectomy procedures and hyperthermic intraperitoneal chemotherapy. Post operative morbidity may be increased due to "non-surgical" complications. ( C) 2001 Harcourt Publishers Ltd.