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. 2021 Apr;12(Suppl 1):S91-S98.
doi: 10.21037/jgo-20-46.

Hyperthermic intra-operative intraperitoneal chemotherapy as an adjuvant to pancreatic cancer resection

Antonios-Apostolos K Tentes  1
Affiliations

Hyperthermic intra-operative intraperitoneal chemotherapy as an adjuvant to pancreatic cancer resection

Antonios-Apostolos K Tentes. J Gastrointest Oncol. 2021 Apr.

Abstract

Background: Even after potentially curative resection the long-term survival of pancreatic cancer is poor. The local-regional failures are frequent. Previous studies have shown that adjuvant treatment with hyperthermic intra-operative intraperitoneal chemotherapy (HIPEC) may effectively control local disease. The objective of the study is to update the results of the prior publications by integrating data from recently accrued cases. Also, to revisit the clinical and pharmacological rationale for the intraperitoneal administration of chemotherapy in pancreatic cancer patients undergoing potentially curative resection.

Methods: This is a prospective study of pancreatic cancer patients that underwent R0 resection in combination with HIPEC-gemcitabine. Morbidity and mortality were recorded. Survival was calculated and the sites for recurrent disease were recorded.

Results: The updated results for 33 patients that underwent treatment until 2016 and for 6 more patients that were included until 2018 were presented. The hospital mortality and morbidity rate were 5.1% (2 patients), and 28.2% (11 patients) respectively. The median and 5-year survival rate was 17 months and 24% respectively. With a median follow-up time of 13 months 23 patients (59%) were recorded with recurrence. Local regional failures were recorded in 4 patients (10.3%).

Conclusions: HIPEC following R0 resection is a feasible and safe adjuvant treatment for pancreatic cancer. The local-regional failures appear to be significantly decreased and to result in an increased overall survival. Further studies with combined intraperitoneal and systemic perioperative chemotherapy may serve to supplement our data with an increased benefit for patients having pancreas cancer resection.

Keywords: Pancreatic cancer; gemcitabine; hyperthermic intra-operative intraperitoneal chemotherapy (HIPEC); intraperitoneal chemotherapy; local recurrence; perioperative chemotherapy; peritoneal metastases; r0 resection.

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Conflict of interest statement

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jgo-20-46). The focused issue was sponsored by the Peritoneal Surface Oncology Group International (PSOGI). The author has no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Overall survival of 39 patients with pancreatic cancer undergoing R0 resection and HIPEC.
See this image and copyright information in PMC

Comment in

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