Intraperitoneal hyperthermic chemotherapy: experience at Baylor University Medical Center

Joseph A. Kuhn, MD, James M. McLoughlin, MD, Daniel C. Harris, MD, Loraye J. Talaasen, RN, Steven W. Sutton, LP, CCP, and Todd M. McCarty, MD

From the Department of Surgery, Baylor University Medical Center, Dallas, Texas.

Corresponding author: Joseph A. Kuhn, MD, 3409 Worth Street, Suite 420, Dallas, Texas 75246 (e-mail: kuhndallas@aol.com).

Context: Patients with peritoneal carcinomatosis have a dismal prognosis despite systemic chemotherapy or palliative surgery. A novel strategy of complete tumor debulking with intraoperative hyperthermia with chemotherapy has been proposed to provide prolonged survival.

Objective: To retrospectively analyze the preliminary experience with this technique at Baylor University Medical Center.

Methods: All patients underwent attempted tumor debulking followed by intraperitoneal hyperthermia with 40 mg mitomycin-C over 2 hours.

Results: Patient diagnoses included nonmucinous colorectal carcinomatosis (n = 9), diffuse peritoneal adenomucinosis (n = 1), peritoneal mucinous carcinomatosis (n = 2), and gastric carcinomatosis (n = 3). Tumors in most patients (13/15) were resected to <=5 mm, and those in 10 of 15 were resected to no gross disease. Complications included ileus (n = 9), bowel leak (n = 2), infection (n = 1), and fistula (n = 1). One patient died of progressive gastric cancer at 1 month. Within a median follow-up of 4 months, 8 patients had no tumor by radiologic or tumor marker analysis.

Conclusion: Intraoperative hyperthermia with chemotherapy is a viable treatment for patients with isolated peritoneal carcinomatosis from colorectal or gastric origin. (BUMC Proceedings 2002;15:359-362)