Outcomes following interval debulking surgery in primary peritoneal carcinoma.

Abstract

e15515 Background: Primary peritoneal carcinoma (PPC) has a poor prognosis with a median survival of 12-25 months. Unlike ovarian cancer, there is no published data on the effectiveness of interval debulking surgery (IDS) in PPC and it is not routine practice. Our series aimed to compare outcomes in patients with PPC treated with IDS following chemotherapy compared with patients treated with chemotherapy alone. Methods: A retrospective case note analysis was undertaken of all patients' of two consultants in 4 hospitals in the West Midlands diagnosed with PPC between May 2000-Nov 2008 identified through medical records. Data was analysed for age, performance status, response to chemotherapy, surgical outcomes, subsequent treatments, site of relapse, median time to progression (TTP), and median overall survival (OS). Analysis for TTP and OS was undertaken using both Kaplan-Meier and log rank analysis. Results: We identified 44 patients with histologically proven PPC between May 2000-October 2008. 41 patients received chemotherapy. 19 received Carboplatin alone, 20 Carboplatin-Paclitaxel and 2 Carboplatin-Gemcitabine. 17/44 patients (39%) went on for IDS following chemotherapy and 15/17 had optimal debulking. 3/17 had a complete pathological response. To date 11/17(65%) patients have recurred in the interval surgical group compared with 24/27(89%) in the non-interval surgery group. Median TTP was 25m (range = 8-33m) vs. 9m (0-30m) p=0.0001. 14/17(82%) in the surgical group have reached 2-year survival vs. 10/27(37%) in the non-surgical group. Median OS was 48 months in the interval surgery group vs. 21 months in the non-surgical group, p=0.0006. The median OS for all patients was 36 months. Conclusions: The median OS for all patients was 36m which compares favourably with previously published survival data of 12-25 months. IDS in selected cases of PPC seems to improve median OS and TTP in PPC and should be considered in all patients who have a good response to chemotherapy.