Multimodal management of peritoneal sarcomatosis in uterine sarcoma: Long term outcomes from a single institute in India.

OBJECTIVE

To assess the outcomes of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal sarcomatosis (PS) from uterine sarcoma at a tertiary oncology center in India.

METHODS

A retrospective analysis of uterine sarcoma patients with PS who underwent CRS + HIPEC. Key outcomes included survival, completeness of cytoreduction (CC score), and postoperative morbidity.

RESULTS

Median patient age was 53 years, with uterine leiomyosarcoma and endometrial stromal sarcoma as the predominant histology. All patients received preoperative chemotherapy, mainly gemcitabine/docetaxel or ifosfamide. The median Peritoneal Carcinomatosis Index (PCI) was 12, with 85 % of patients having PCI < 15. Complete cytoreduction (CC-0) was achieved in 94 %. Median overall survival (OS) was 34 months, with 1-year, 3-year, and 5-year OS rates of 78 %, 53 %, and 35 %. Disease recurrence remained high (67 %), with a median progression-free survival (PFS) of 14 months.

CONCLUSION

CRS + HIPEC is a promising therapeutic approach for select uterine sarcoma patients with PS, offering high cytoreduction rates and extended survival. Further studies are needed to optimize patient selection and refine treatment protocols.