Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy vs. cytoreductive surgery alone for intrahepatic cholangiocarcinoma with peritoneal metastases: A retrospective cohort study.

Abstract

BACKGROUND\nCytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has survival benefits in patients with intraperitoneal malignant lesions, but there is no study specific to intrahepatic cholangiocarcinoma (ICC).\n\n\nPURPOSE\nTo compare the prognosis of patients with advanced ICC undergoing CRS\xa0+\xa0HIPEC compared with CRS alone.\n\n\nMETHODS\nThis study was a retrospective cohort study of patients with advanced ICC treated at the Shanghai Eastern Hepatobiliary Surgery Hospital between 01/2014 and 12/2018. The patients were divided into either CRS\xa0+\xa0HIPEC or CRS group based on the treatment they received. Overall survival (OS), complications, hospital stay, biochemical indicators, tumor markers, and number of HIPEC were examined.\n\n\nRESULTS\nThere were 51 and 61 patients in the CRS\xa0+\xa0HIPEC and CRS groups, respectively. There were no differences between the groups regarding preoperative CA19-9 levels (421\xa0±\xa0381 vs. 523\xa0±\xa0543 U/mL, P\xa0=\xa00.208). The hospital stay was longer in the CRS\xa0+\xa0HIPEC group (22.2\xa0±\xa010.0 vs. 18.6\xa0±\xa07.6 days, P\xa0=\xa00.033). The occurrence of overall complications was similar in the two groups (37.2% vs. 34.4%, P\xa0=\xa00.756). The postoperative CA19-9 levels were lower in the CRS\xa0+\xa0HIPEC group compared with the CRS group (196\xa0±\xa0320 vs. 337\xa0±\xa0396 U/mL, P\xa0=\xa00.044). The median OS was longer in the CRS\xa0+\xa0HIPEC group than in the CRS group (25.53 vs. 11.17 months, P\xa0<\xa00.001). Compared with the CRS group, the CRS\xa0+\xa0HIPEC group showed a higher occurrence of leukopenia (7.8% vs. 0, P\xa0=\xa00.040) but a lower occurrence of total bilirubin elevation (15.7% vs. 37.7%, P\xa0=\xa00.032).\n\n\nCONCLUSION\nCRS\xa0+\xa0HIPEC could be a treatment option for patients with advanced ICC, with improved OS and similar complications and adverse events compared with CRS alone.