Survival outcomes and prognostic factors in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: A single-center retrospective study

Abstract

Background

Peritoneal carcinomatosis (PC) represents an advanced stage of intra-abdominal malignancies with poor prognosis. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) offers promising outcomes in selected patients. This study evaluated survival and prognostic factors in patients undergoing CRS-HIPEC for malignancy-associated PC.

Methods

A retrospective analysis was performed on 116 patients treated with CRS-HIPEC between 2015 and 2023. Data included demographics, tumor origin, peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, complications, and survival outcomes. Kaplan–Meier and Cox regression analyses were used.

Results

The mean age was 55.2 years; 61.2% were female. Common primary tumors were colorectal (34.5%), gastric (20.7%), ovarian (17.2%), and appendiceal (16.4%). Mean PCI was 11.9, and complete cytoreduction (CC-0) was achieved in 89.7%. Overall survival was highest in appendiceal (76.9 months) and lowest in gastric cancer (24.7 months). Median disease-free and overall survival were 36 and 43.9 months, respectively. Postoperative complications occurred in 31.8%; mortality was 5.17%. High PCI and incomplete cytoreduction were independently associated with worse survival.

Conclusion

CRS-HIPEC provides encouraging survival in selected PC patients, especially with low PCI and complete cytoreduction. Careful patient selection remains key to optimizing outcomes.