Cytoreduction and HIPEC in the treatment of "unconventional" XXXX .

@entity1 @entity43 @entity137 @entity5 @entity189 @entity2615 @entity1725 @entity1104 @entity298 @entity14105
BACKGROUND: Peritoneal metastasis (PM) is considered a terminal and incurable disease. In the last 30  years, @entity1104 ( @entity1104 ) and hyperthermic intraperitoneal chemotherapy (HIPEC) radically changed the therapeutic approach for these @entity1 and is regarded as the standard of care for @entity1725 from @entity5 and peritoneal @entity2615 . Improved survival has also been reported in treating PM from @entity43 . However, PM often seriously complicates the clinical course of @entity1 with other primary digestive and non-digestive cancers. There is increasing literature evidence that helped to identify not only the @entity5 for which @entity1104 and HIPEC showed a survival advantage but also the @entity1 who may benefit form this treatment modality for the potential lethal complications. Our goal is to report our experience with cytoreduction and HIPEC in @entity1 with PM from rare or unusual @entity5 , discussing possible "unconventional" indications, outcome, and the peculiar issues related to each @entity5 . METHODS: From a series of 253 consecutive @entity1 with a diagnosis of peritoneal @entity189 and treated by @entity1104 and HIPEC, we selected only those with @entity298 from rare or unusual @entity5 , excluding @entity1725 , peritoneal @entity2615 , @entity43 . Complications and adverse effects were graded from 0 to 5 according to the WHO Common @entity137 Criteria for Adverse Events (CTCAE). Survival was expressed as mean and median. RESULTS: We admitted and treated by @entity1104 and HIPEC 28 @entity1 with @entity298 from rare or unusual @entity5 . Morbidity and mortality rates were in line with those reported for similar procedures. Median survival for the study group was 56  months, and 5-year overall survival reached 40.3  %, with a difference between @entity1 with no (CC0) and minimal ( @entity14105 ) residual disease (52.3 vs. 25.7), not reaching statistical significance. Ten @entity1 are alive disease-free, and eight are alive with disease. CONCLUSIONS: Cytoreduction and HIPEC should not be excluded "a priori" for the treatment of peritoneal metastases from unconventional @entity5 . This combined therapeutic approach, performed in an experienced center, is safe and can provide a survival benefit over conventional palliative treatments.
