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Hyperthermic Intraperitoneal Chemotherapy Thwarts Recurrent Ascites From Appendiceal Cancer: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 8, 2010 -- Hyperthermic intraperitoneal chemotherapy (HIPEC) prevents recurrent mucinous ascites from appendiceal cancer, according to data released on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). Mucinous ascites can significantly reduce the quality of life in patients with appendiceal cancer. Intraperitoneal chemotherapy with or without hyperthermia has been shown to prevent reaccumulation of malignant ascites from nonappendiceal cancers, including gastric and colorectal cancers, explained study author Laura A. Lambert, MD, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts. In this retrospective study, Dr. Lambert and colleagues reviewed the records of 134 patients who underwent cytoreductive surgery and HIPEC with mitomycin C for appendiceal cancer. The research team identified 8 (6%) patients with mucinous ascites who underwent HIPEC after incomplete cytoreduction and then determined the incidence of recurrent ascites, as well as morbidity, mortality, and overall survival. “Symptomatic, large-volume mucinous ascites is a common complication of appendiceal neoplasms,” Dr. Lambert observed. “Many patients undergo multiple paracenteses; however, paracentesis is often ineffective due to the mucinous nature of the fluid.” The median length of follow-up was 23.5 months, and the median overall survival was 26 months. At last follow-up, 5 patients had no evidence of ascites by computed tomography. Three patients had possible minimal ascites. The average volume of ascites was 4L (range, 2.0-8.5 L). The researchers identified no perioperative deaths; although, grade 3/4 morbidity was reported with 1 (12.5%) patient. No patient needed to be treated for ascites-related symptoms. Dr. Lambert said that that this study is the first to report the ability of HIPEC to prevent the reaccumulation of ascites from appendiceal cancer. However, possible study limitations are its retrospective design and small number of patients, she added. Also, many patients received post-HIPEC systemic therapy, including bevacizumab. “Given the high morbidity associated with aggressive cytoreductive surgery, the palliative role of HIPEC without cytoreductive surgery in the management of malignant ascites merits further study,” she added. [Presentation title: Hyperthermic Intraperitoneal Chemotherapy Prevents Recurrence of Mucinous Ascites From Appendiceal Cancer. Abstract P152] E-mail this page to a friend or colleague! To print, use this version