Safety and preliminary efficacy of intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in 100 pediatric patients with solid tumors: a retrospective study.

BACKGROUND

Peritoneal recurrence challenges pediatric solid tumors. HIPEC is established in adults but pediatric evidence is limited. We assessed safety and preliminary efficacy of intraoperative HIPEC in children.

RESEARCH DESIGN AND

METHODS

Retrospective study of 100 children (Aug 2020-Jan 2024) undergoing cytoreductive surgery (CRS) plus HIPEC (cisplatin, doxorubicin, or ifosfamide at 40.5-41.5°C for 60 min). Outcomes included complications, recurrence, and survival.

RESULTS

The median peritoneal carcinomatosis index was 4.0 (IQR: 8.0), and complete cytoreduction (CC-0) was achieved in 96% of patients. Adverse events were primarily grade 1-2 gastrointestinal toxicity (90%) and myelosuppression (93%); grade 3 events occurred in 10% and 7%, respectively. No grade 4+ adverse events or 30-day mortality were observed. Transient liver enzyme elevation (49%) normalized within one month. At a median follow-up of 24.3 months, the median overall and progression-free survival were 25.2 and 24.6 months, respectively. Seven patients experienced recurrence recurred and ten died.

CONCLUSIONS

HIPEC demonstrated low rates of severe complications and promising survival outcomes. The main limitations include the retrospective design and tumor heterogeneity. Therefore, Large-scale prospective studies are warranted to validate these findings.