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05.07.2018 | Gastrointestinal Oncology | Ausgabe 11/2018

Annals of Surgical Oncology 11/2018

Impact of Combination Chemotherapy in Peritoneal Mesothelioma Hyperthermic Intraperitoneal Chemotherapy (HIPEC): The RENAPE Study

Annals of Surgical Oncology > Ausgabe 11/2018
MD, MSc Brice Malgras, MD, PhD Etienne Gayat, MD Olivier Aoun, MD, PhD Réa Lo Dico, MD, PhD Clarisse Eveno, MD Karine Pautrat, MD, MSc Jean-Baptiste Delhorme, MD, PhD Guillaume Passot, MD, PhD Frédéric Marchal, MD, PhD Olivia Sgarbura, MD, PhD Gwenael Ferron, MD, PhD Diane Goéré, MD, PhD Thierry Andre, MD, PhD Marc Pocard, on behalf of the RENAPE Network
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-018-6631-2) contains supplementary material, which is available to authorized users.
Collaborators [RENAPE - French National Network of Peritoneal Surface Malignancies] are listed at the end of the manuscript (in the Acknowledgements).



The introduction of cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) improved the prognosis of selected patients with peritoneal mesothelioma (PM).


The objective of our study was to evaluate whether different HIPEC agents were associated with different outcomes in patients with PM.


From the RENAPE database, we selected all patients with histology-proven PM who underwent CRS + HIPEC from 1989 to 2014. Inclusion criteria were age ≤ 80 years, performance status ≤ 2, and no extraperitoneal metastases.


Overall, 249 patients underwent CRS + HIPEC for PM. The HIPEC regimen included five chemotherapeutic agents (CAs), consisting of cisplatin, doxorubicin, mitomycin-C, oxaliplatin, and irinotecan. When considering all CAs (alone or in combination), there was no significant statistical difference in regard to postoperative overall survival (OS). However, OS was better when using two CAs (group 2 drugs) versus one CA (group 1 drug) (p = 0.03). The different CA regimens were equally distributed between the two groups. This association between OS and HIPEC agent, as well as a trend for better progression-free survival, were both observed in the two-drug group versus the one-drug group (p = 0.009) for patients undergoing complete cytoreductive surgery (CC-0) with an epithelioid subtype.


This large study seems to show improved OS when combined CAs, especially with platinum-based regimens, are used for HIPEC in patients with PM, but needs to be confirmed by a randomized controlled trial.

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Supplementary material 1 (tiff 1143 kb)
Supplementary material 1 (tiff 1143 kb)
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