Factors predicting survival after intraperitoneal hyperthermic chemotherapy with mitomycin C after cytoreductive surgery for patients with peritoneal carcinomatosis

Abstract

Hypothesis: Certain clinicopathologic factors predict improved survival after cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Design: Prospective clinical trial. Setting: Surgical oncology service at a university academic hospital. Patients: A population of 109 consecutive patients with peritoneal carcinomatosis treated between December 1991 and November 1997. Intervention: All patients underwent resection of gross disease followed by 2-hour intraoperative perfusion of mitomycin C (20-40 mg) into the peritoneal cavity at a temperature of 40.5°C. Main Outcome Measures: Clinicopathologic factors that independently predicted improved overall survival rates. Results: Overall survival at 1 and 3 years was 61% and 33%, respectively. With median follow-up of 52 months, median overall survival was 16 months. Four factors were significant independent predictors of improved survival by multivariate analysis: nonadenocarcinoma histologic features (P=.001), the appendix as a primary site (P=.003), the absence of hepatic parenchymal metastases (P=.01), and complete resection of all gross disease (R1/0 resection) (P