Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for disseminated intra-abdominal malignancies in children-a single-institution experience

J Pediatr Surg. 2018 Jul;53(7):1381-1386. doi: 10.1016/j.jpedsurg.2017.09.014. Epub 2017 Oct 2.

Abstract

Purpose: Our purpose was to present our institutional experience with performing complete cytoreduction surgery and heated intraoperative chemotherapy (CRS-HIPEC) for children with disseminated intraabdominal malignancies, guided by a leading international center performing CRS-HIPEC in children.

Methods: Retrospective chart review of all cases of CRS-HIPEC in children in our institution, examining diagnosis, preoperative management, operative management, postoperative treatment, short term outcome including length of stay and complications, and long term outcome including survival and recurrence of disease.

Results: 9 children underwent CRS-HIPEC over 48months. The mean age of the patients was 8years. Tumors were: rhabdomyosarcoma (RMS), mesothelioma, Sertoli-Leydig, desmoplastic small round cell tumor, colon carcinoma and Wilms' tumor. Most patients received intraperitoneal cisplatin. Short term outcome was very good with median length of hospital stay of 13days and low rate of complications. Seven patients were alive at last follow up. Five patients developed a recurrent disease. Recurrence was intraabdominal in two of these patients.

Conclusions: CRS-HIPEC for children with disseminated intraabdominal malignancies performed in a dedicated institution and with guidance by a leading international center can be performed safely.

Type of study: Treatment study.

Level of evidence: IV.

Keywords: Children; Cytoreduction; Heated intraperitoneal chemotherapy; Intraabdominal dissemination.

MeSH terms

  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Child
  • Cytoreduction Surgical Procedures / methods*
  • Follow-Up Studies
  • Humans
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery*
  • Retrospective Studies