{"id":4934,"date":"2024-07-17T08:50:02","date_gmt":"2024-07-17T08:50:02","guid":{"rendered":"https:\/\/www.viamedsalud.com\/ivoqa\/uncategorized\/survival-after-hipec-in-peritoneal-carcinomatosis-treatment-and-expectations\/"},"modified":"2025-04-08T08:10:08","modified_gmt":"2025-04-08T08:10:08","slug":"survival-after-hipec-in-peritoneal-carcinomatosis-treatment-and-expectations","status":"publish","type":"post","link":"https:\/\/www.viamedsalud.com\/ivoqa\/en\/treatments\/hipec-en\/survival-after-hipec-in-peritoneal-carcinomatosis-treatment-and-expectations\/","title":{"rendered":"Survival after HIPEC in peritoneal carcinomatosis: treatment and expectations"},"content":{"rendered":"<p>Cytoreductive surgery is a major surgical procedure aimed at removing all visible tumor tissue. This treatment is critical to improve the chances of long-term survival and is often combined with hyperthermic intraperitoneal chemotherapy <a href=\"https:\/\/www.viamedsalud.com\/ivoqa\/en\/hipec\/\">(HIPEC<\/a>).<\/p>\n<p>HIPEC involves the administration of heated chemotherapy directly into the peritoneal cavity immediately after cytoreductive surgery. This approach allows higher concentrations of chemotherapy in the affected area, improving its efficacy and reducing systemic side effects. In this regard, survival in peritoneal carcinomatosis varies widely and depends on several factors.<\/p>\n<h2><strong>Factors Affecting Survival After HIPEC<\/strong><\/h2>\n<p>Factors affecting survival after HIPEC treatment in peritoneal carcinomatosis:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.viamedsalud.com\/ivoqa\/en\/disease\/peritoneal-carcinomatosis\/peritoneal-carcinomatosis-index-what-is-it\/\">Peritoneal carcinomatosis index (PCI)<\/a>. PCI is a score that reflects the extent of disease in the peritoneum. Patients with a lower PCI have better survival.<\/li>\n<li>Type of primary tumor. Survival is generally better for patients with tumors of ovarian or appendiceal origin than for those with tumors of gastric or colorectal origin.<\/li>\n<li>Disease stage. Survival is better for patients with early stage disease with low PCI and exclusively peritoneal metastases than for those with advanced stage disease with high PCI and\/or extraperitoneal metastases.<\/li>\n<li>Completeness of cytoreduction. Cytoreduction is surgery to remove as much disease as possible. Survival is best for patients who achieve complete cytoreduction (CC-0), where there is no residual gross disease.<\/li>\n<\/ul>\n<h2><strong>Survival rates after HIPEC<\/strong><\/h2>\n<p>Survival in peritoneal carcinomatosis by cancer type.<\/p>\n<p><u>Peritoneal cancer of colorectal origin.<\/u><\/p>\n<ul>\n<li>Median survival is between 42 and 46 months after cytoreductive surgery and HIPEC.<\/li>\n<li>Sixteen percent of patients do not relapse peritoneally. However, for patients who relapse peritoneally, it is possible to perform a second or third iterative cytoreductive surgery and HIPEC, which can significantly extend survival.<\/li>\n<\/ul>\n<p><u>Peritoneal cancer of gastric origin<\/u><\/p>\n<ul>\n<li>Peritoneal metastases are common in late stage gastric cancer and these patients have a poor prognosis despite systemic chemotherapy.<\/li>\n<li>Median survival with cytoreductive surgery and HIPEC is less than 18 months.<\/li>\n<li>New approaches, such as reoperation with HIPEC, intravenous chemotherapy combined with intraperitoneal chemotherapy strategies such as PIPAC (pressurized aerosolized intraperitoneal chemotherapy) and NIPEC (normothermic intraperitoneal chemotherapy), are showing promising results and more trials are underway.<\/li>\n<\/ul>\n<p><u>Pseudomyxoma peritonei<\/u><\/p>\n<ul>\n<li>Low-grade pseudomyxoma peritonei: median survival of more than 10 years with cytoreductive surgery and HIPEC.<\/li>\n<li>High-grade pseudomyxoma peritonei: median survival below five years.<\/li>\n<\/ul>\n<p><u>Peritoneal mesothelioma<\/u><\/p>\n<ul>\n<li>Combined treatment comprising cytoreductive surgery and HIPEC results in a median overall survival of 53 months in patients with peritoneal mesothelioma, but is radically inferior for mesotheliomas with aggressive subtypes.<\/li>\n<li>With systemic chemotherapy: median survival of 27 months.<\/li>\n<\/ul>\n<p><u>Ovarian Cancer<\/u><\/p>\n<ul>\n<li>The addition of cytoreductive surgery and HIPEC to the treatment of ovarian cancer and peritoneal carcinomatosis adds more than one year of survival.<\/li>\n<li>The role of cytoreductive surgery combined with HIPEC appears promising, especially for platinum-resistant ovarian cancer. In a randomized study, interval surgery plus HIPEC followed by systemic chemotherapy versus surgery alone followed by systemic chemotherapy resulted in a median survival of 19.4 months versus 11.2 months, respectively.<\/li>\n<\/ul>\n<p><u>Other tumors<\/u><\/p>\n<ul>\n<li>Pancreatic cancer with peritoneal metastases: median survival of 16 months with cytoreductive surgery and HIPEC.<\/li>\n<li>Cholangiocarcinoma with peritoneal metastases: median survival of 21.4 months.<\/li>\n<li>Sarcomatosis with peritoneal metastases: survival between 12 and 34 months.<\/li>\n<\/ul>\n<h2><strong>Quality of life after HIPEC<\/strong><\/h2>\n<p>After an operation with cytoreduction surgery and HIPEC there may be complications derived from major abdominal surgery: infection, bleeding, anastomotic leak, respiratory or urinary infections, etc. In addition, there are the possible complications derived from chemotherapy (lowering of white blood cells, platelets, alteration of renal function).<\/p>\n<p>For this reason, this surgery must be performed by expert teams and within a preoperative pre-habilitation and ERAS (Early Postoperative Recovery) program to reduce complications or their impact.<\/p>\n<p>Cytoreduction surgery combined with HIPEC is performed in most patients with curative intent. With potential for cure and long-term survival, the risk of perioperative morbidity and mortality appears acceptable, but should be evaluated on an individualized basis for each patient by an expert tumor committee.<\/p>\n<h2><strong>Innovations and Advances in HIPEC Treatment<\/strong><\/h2>\n<p>There are numerous clinical trials investigating the effectiveness and safety of HIPEC in different types of cancer and with different treatments:<\/p>\n<p>New drugs. New drugs are being tested for use in HIPEC. These include nanotechnology, heat-sensitizing agents and targeted therapies.<\/p>\n<p>New delivery techniques. New techniques are being developed to deliver drugs during HIPEC, including the use of perfusion pumps and special catheters.<\/p>\n<p>Combination therapy. HIPEC is being combined with other treatments, such as radiation and immunotherapy.<\/p>\n<p>Intraperitoneal personalized medicine. The use of targeted molecular panels and organoids allows the design of personalized therapies at the systemic and intraperitoneal level.<\/p>\n<p>The combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) offers significant hope for patients with peritoneal carcinomatosis. Factors influencing survival vary, including tumor type, stage of disease, and radicality of cytoreduction. Despite the associated risks, this treatment can extend survival and improve quality of life in many cases. Continued research and advances in techniques and drugs for HIPEC promise to further improve outcomes for these patients.<\/p>\n<p>References: Cort\u00e9s-Guiral, D., H\u00fcbner, M., Alyami, M. et al. Primary and metastatic malignant neoplasms of the peritoneal surface. Nat Rev Dis Primers 7, 91 (2021). <a href=\"https:\/\/doi.org\/10.1038\/s41572-021-00326-6\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1038\/s41572-021-00326-6<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Improved survival in peritoneal carcinomatosis with HIPEC and cytoreductive surgery. Learn about key factors and advances in this innovative treatment.<\/p>\n","protected":false},"author":1,"featured_media":4926,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[63],"class_list":["post-4934","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hipec-en","tag-featured"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Survival after HIPEC in peritoneal carcinomatosis - IVOQA<\/title>\n<meta name=\"description\" content=\"Improved survival in peritoneal carcinomatosis with HIPEC and cytoreductive surgery. 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