AB105. SOH22ABS086. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in small bowel adenocarcinoma with peritoneal carcinomatosis: a systematic review
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AB105. SOH22ABS086. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in small bowel adenocarcinoma with peritoneal carcinomatosis: a systematic review

Chen Vicky1, Morgan Jones2

1Peter MacCallum Cancer Centre, Melbourne, Australia; 2Alfred Health, Melbourne, Australia

Background: Small bowel adenocarcinoma (SBA) with peritoneal carcinomatosis (PC) is rare and despite treatment with systemic chemotherapy, the prognosis is poor. However, there is emerging evidence that cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) may offer a survival benefit over systemic therapy alone. This systematic review will assess the effectiveness of CRS-HIPEC for SBA-PC.

Methods: Three databases were searched from inception to 11/10/2021. Clinical outcomes were extracted and analysed.

Results: A total of 164 cases of SBA-PC patients undergoing CRS-HIPEC were identified in 12 studies. The majority of patients had neoadjuvant chemotherapy (87/164, 53%) and complete cytoreduction (143/164, 87%) prior to HIPEC. The mean overall survival was 9- to 32-month and 5-year survival ranged from 25–40%. Clavien-Dindo grade III/IV morbidity ranged between 19.1–50%, while overall mortality was low with only 3 treatment-related deaths.

Conclusions: CRS-HIPEC has the potential to improve the overall survival in a highly select group of SBA-PC patients, with 5-year survival rates comparable to those reported in colorectal peritoneal metastases. However, the expected survival benefits need to be balanced against the intrinsic risk of morbidity and mortality associated with the procedure. Further multicentre studies are required to assess the safety and feasibility of CRS-HIPEC in SBA-PC to guide best practice management for this rare disease.

Keywords: Cytoreductive surgery (CRS); general surgery; hyperthermic intraperitoneal chemotherapy (HIPEC); small bowel adenocarcinoma (SBA); systematic review

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab105
Cite this abstract as: Vicky C, Jones M. AB105. SOH22ABS086. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in small bowel adenocarcinoma with peritoneal carcinomatosis: a systematic review. Mesentery Peritoneum 2022;6:AB105.

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