Objectives: peritoneal surface malignancy in children is
rare with a dismal prognosis. This bicentric study evaluated
CRS with HIPEC in patients aged 2–25 years.
Methods: Clinicopathological and treatment-related factors
were retrospectively analyzed from 21 patients undergoing
CRS and HIPEC between 2009 and 2022. Endpoints were
feasibility, chemotherapeutic compound, complications, and
overall survival (OS).
Results: The mean age was 20.4 years. The mean peritoneal
cancer index (PCI) was 12.8. Mean follow-up period was 6.8
years. Median overall survival time was 2.4. 5-year survival
rate was 42.9 %. 76.2 % had primary and 23.8 % recurrent
disease. The most common primary tumor locations were
colon (33.3 %) and appendix (14.3 %). Adenocarcinoma was
the most common histological subtype (71.4 %). Univariable
Cox regression analysis showed significant impaired OS
after previous chemotherapy (p=0.46) and incomplete
cytoreduction CCR-2 (p=0.43). No perioperative mortalities
occurred. The incidence of major complications was 24 %.
Conclusions: Multimodal treatment can be considered in
pediatric patients with peritoneal carcinomatosis. It
presents a safe and feasible therapy with manageable complications
and no perioperative mortality when performed
by an experienced multidisciplinary team. Indication for
CRS and HIPEC in children should be an individual decision
by an interdisciplinary tumor board in the absence of better
alternatives.