TY - JOUR
T1 - The impact of HIPEC vs. EPIC for the treatment of mucinous appendiceal carcinoma
T2 - a study from the US HIPEC collaborative
AU - Leiting, Jennifer L.
AU - Day, Courtney N.
AU - Harmsen, William S.
AU - Cloyd, Jordan M.
AU - Abdel-Misih, Sherif
AU - Fournier, Keith
AU - Lee, Andrew J.
AU - Dineen, Sean
AU - Dessureault, Sophie
AU - Veerapongh, Jula
AU - Baumgartner, Joel M.
AU - Clarke, Callisia
AU - Mogal, Harveshp
AU - Russell, Maria C.
AU - Zaidi, Mohammad Y.
AU - Patel, Sameer H.
AU - Morris, Mackenzie C.
AU - Hendrix, Ryan J.
AU - Lambert, Laura A.
AU - Abbott, Daniel E.
AU - Pokrzywa, Courtney
AU - Raoof, Mustafa
AU - Eng, Oliver
AU - Johnston, Fabian M.
AU - Greer, Jonathan
AU - Grotz, Travis E.
N1 - Publisher Copyright:
© 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Introduction: Mucinous appendiceal carcinoma is a rare malignancy that commonly spreads to the peritoneum leading to peritoneal metastases. Complete cytoreduction with perioperative intraperitoneal chemotherapy (PIC) is the mainstay of treatment, administered as either hyperthermic intra peritoneal chemotherapy (HIPEC) or early post-operative intraperitoneal chemotherapy (EPIC). Our goal was to assess the perioperative and long term survival outcomes associated with these two PIC methods. Materials and methods: Patients with mucinous appendiceal carcinoma were identified in the US HIPEC Collaborative database from 12 academic institutions. Patient demographics, clinical characteristics, and survival outcomes were compared among patients who underwent HIPEC vs. EPIC with inverse probability weighting (IPW) used for adjustment. Results: Among 921 patients with mucinous appendiceal carcinoma, 9% underwent EPIC while 91% underwent HIPEC. There was no difference in Grade III–V complications between the two groups (18.5% for HIPEC vs. 15.0% for EPIC, p=.43) though patients who underwent HIPEC had higher rates of readmissions (21.2% vs. 8.8%, p<.01). Additionally, PIC method was not an independent predictor for overall survival (OS) or recurrence-free survival (RFS) after adjustment on multivariable analysis. Conclusions: Among patients with mucinous appendiceal carcinoma, both EPIC and HIPEC appear to be associated with similar perioperative and long-term outcomes.
AB - Introduction: Mucinous appendiceal carcinoma is a rare malignancy that commonly spreads to the peritoneum leading to peritoneal metastases. Complete cytoreduction with perioperative intraperitoneal chemotherapy (PIC) is the mainstay of treatment, administered as either hyperthermic intra peritoneal chemotherapy (HIPEC) or early post-operative intraperitoneal chemotherapy (EPIC). Our goal was to assess the perioperative and long term survival outcomes associated with these two PIC methods. Materials and methods: Patients with mucinous appendiceal carcinoma were identified in the US HIPEC Collaborative database from 12 academic institutions. Patient demographics, clinical characteristics, and survival outcomes were compared among patients who underwent HIPEC vs. EPIC with inverse probability weighting (IPW) used for adjustment. Results: Among 921 patients with mucinous appendiceal carcinoma, 9% underwent EPIC while 91% underwent HIPEC. There was no difference in Grade III–V complications between the two groups (18.5% for HIPEC vs. 15.0% for EPIC, p=.43) though patients who underwent HIPEC had higher rates of readmissions (21.2% vs. 8.8%, p<.01). Additionally, PIC method was not an independent predictor for overall survival (OS) or recurrence-free survival (RFS) after adjustment on multivariable analysis. Conclusions: Among patients with mucinous appendiceal carcinoma, both EPIC and HIPEC appear to be associated with similar perioperative and long-term outcomes.
KW - Mucinous appendiceal carcinoma
KW - cytoreductive surgery
KW - early post-operative intraperitoneal chemotherapy
KW - hyperthermic intraperitoneal chemotherapy
KW - multi-institutional
UR - https://www.scopus.com/pages/publications/85092476058
U2 - 10.1080/02656736.2020.1819571
DO - 10.1080/02656736.2020.1819571
M3 - Article
C2 - 33040617
AN - SCOPUS:85092476058
SN - 0265-6736
VL - 37
SP - 1182
EP - 1188
JO - International Journal of Hyperthermia
JF - International Journal of Hyperthermia
IS - 1
ER -