Long-term survival is possible using cytoreductive surgery plus HIPEC for sarcomatosis—Case report of 2 patients.

• Sarcomatosis is the progression of visible malignant nodules on peritoneal surfaces. • Long-term disease-free survival is unusual if high grade sarcomatosis is treated by CRS and HIPEC. • In two patients prolonged disease-free survival has been observed with complete resection of low grade disease plus HIPEC. • The lack of deep tissue invasion with low grade sarcoma may account for the long-term success of CRS and HIPEC. Sarcomatosis results from the dissemination of cells from an abdominal or pelvic primary sarcoma to the peritoneal surfaces. In most patients this is a lethal condition. The clinical and radiologic features of two patients with sarcomatosis were reviewed. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) were used for treatment. Current status of these two patients was available. These two patients had a large extent of disease. In one, a myxoid sarcoma filled the pelvis. In another, all quadrants of the abdomen and pelvis were involved by peritoneal metastases from a uterine leiomyosarcoma. The grade of these two tumors was moderate and low. Surgical resection of all sarcomatosis was performed and this was followed by HIPEC. Clinical and radiologic follow-up at 37 and 58 months after complete cytoreduction show no evidence of disease. An effort to identify patients with sarcomatosis who are predicted to have a complete cytoreduction should occur when these patients are evaluated. Patients with a complete resection and a sarcoma-specific HIPEC may have prolonged disease-free survival. No other treatments for these patients have been described. [ABSTRACT FROM AUTHOR]