Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for gallbladder cancer: a retrospective review

Am Surg. 2014 Jul;80(7):710-3.


Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) often prolongs survival in patients with peritoneal surface disease, yet is generally avoided in patients with peritoneal spread from gallbladder cancer as a result of its aggressive biologic behavior. Therefore, we reviewed our experience with CRS/HIPEC for patients with gallbladder cancer. We retrospectively evaluated the outcomes of CRS/HIPEC procedures performed from 1991 to 2013 using a prospectively maintained database of 1069 procedures. Patient and tumor characteristics, morbidity, mortality, and survival were reviewed. CRS/HIPEC was performed six times in five patients with peritoneal spread from gallbladder cancer. Patients were young (age 28 to 54 years) without pre-existing comorbidities. Eighty per cent had an Eastern Cooperative Oncology Group score of 0 or 1. At CRS, organs resected included omentum (n = 4), liver (n = 3), colon (n = 2), ovaries (n = 1), and diaphragm (n = 1). A complete macroscopic cytoreduction of intraperitoneal disease was achieved in every case. Clavien graded major morbidity was 17 per cent. There was no observed mortality. Median and 3-year survival were 22.4 months and 30 per cent, respectively. CRS/HIPEC may be performed safely in patients with peritoneal dissemination from gallbladder cancer. Carefully selected patients with low-volume disease amenable to complete cytoreduction may experience a meaningful survival benefit.

Publication types

  • Evaluation Study

MeSH terms

  • Abdominal Cavity / surgery*
  • Abdominal Neoplasms / mortality
  • Abdominal Neoplasms / secondary*
  • Abdominal Neoplasms / therapy
  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / therapy
  • Adult
  • Antineoplastic Agents / therapeutic use
  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Cisplatin / therapeutic use
  • Colectomy
  • Combined Modality Therapy
  • Diaphragm / surgery
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Gallbladder Neoplasms / mortality
  • Gallbladder Neoplasms / pathology*
  • Hepatectomy
  • Humans
  • Hyperthermia, Induced*
  • Male
  • Middle Aged
  • Mitomycin / therapeutic use
  • Omentum / surgery
  • Ovariectomy
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome


  • Antineoplastic Agents
  • Mitomycin
  • Cisplatin