Palliative effects of an incomplete cytoreduction combined with perioperative intraperitoneal chemotherapy

Objectives: Incomplete cytoreduction often occurs because of overwhelming burden of disease intraperitoneally that limit a successful cytoreduction. The outcome of an incomplete cytoreduction followed by administering perioperative intraperitoneal chemotherapy on whether it prolongs survival or palliates symptoms is yet to be established. Methods: A retrospective review of a prospectively collected database was performed. Eleven patients were identified to have had an incomplete (CC2/3) cytoreduction and received either hyperthermic intraperitoneal chemotherapy or early postoperative intraperitoneal chemotherapy. The symptoms of the patients before and after treatment during follow-up consultations in clinic were noted. Survival analysis was performed using the Kaplan Meier method. Results: The median follow-up period was 19 (range, 0.5-35) months. The overall median survival was 21 months with a 1- and 2-year survival rate of 72% and 36%, respectively. Five of 7 patients with pseudomyxoma peritonei and 2 of 3 patients with colorectal cancer peritoneal carcinomatosis experienced symptom improvement after treatment. Severe postoperative morbidity and achieving symptomatic improvement following treatment seems to be associated with a dismal prognosis. Conclusion: Our results suggest that some patients derive a survival and symptomatic benefits despite an incomplete cytoreductive surgery and perioperative intraperitoneal chemotherapy. The effects of this treatment require further investigation to determine its benefits as a palliative procedure.