Long-Term Survival Outcomes Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis of Hepatocellular Carcinoma patients

Abstract Background: Patients with hepatocellular carcinoma with peritoneal metastasis (HCC-PM) have a poor prognosis. Traditional treatments have limited effects on survival. The safety and efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) have been shown in other peritoneal cancers. This study evaluated the role of CRS+HIPEC in HCC-PM. Methods: A retrospective analysis of HCC-PM patients treated with CRS+HIPEC at Beijing Shijitan Hospital from March 2017 to December 2023 was conducted to assess clinical features, severe adverse events (SAEs), and overall survival (OS) rates. Results: The study population comprised 10 HCC-PM patients who underwent CRS+HIPEC. The median peritoneal cancer index (PCI) was 25, and complete cytoreduction (CC0 ~ 1) was achieved in half of the patients. Three patients experienced SAEs within 30 days postoperatively. The 1-year, 3-year, and 5-year OS rates were 89.0%, 89.0%, and 21.0%, respectively, with a median OS1 of 107.8 months and OS2 of 49.9 months. The median progression-free survival (PFS) was 5.0 months. Conclusion: CRS+HIPEC offers significant benefits to patients with HCC-PM. A selected group of patients may achieve prolonged PFS. Incorporating CRS+HIPEC into the treatment paradigm can thus be considered a strategic therapeutic option for patients with HCC-PM.