Fourteen studies were included for review (n=296): one non-randomised prospective study (n unclear) and 13 retrospective studies (n unclear). Two were classified as level 2 evidence and 12 were classified as level 3 evidence.
Between 47% and 100% of patients achieved complete cytoreduction (12 studies). In eight studies, complete cytoreduction was associated with increase survival (p-values ranged from <0.05 to 0.0001, where stated). Median overall survival ranged from 21.9 months to 54 months (eight studies). In those patients with optimal cytoreduction, median overall survival ranged from 29 months to 55.9 months (four studies). Two year survival rates ranged from 60% to 71% (four studies), three year survival rates ranged from 20% to 63% (six studies) and five-year survival rates ranged from 12% to 63.4% (six studies).
Six studies had no deaths attributable to treatment, four studies had one death attributable to treatment and three studies had two deaths attributable to treatment. One study had four treatment-related deaths, two of which were associated with intravenous mitomycin C. Eight studies reported the occurrence of significant morbidity requiring further invasive procedures, a return to surgical intensive care unit or a return to the operating room. The occurrence of other morbidities in these studies ranged from 5% to 36%. Four other studies reported morbidity rates of 45% to 60%. The most significant adverse events were haematological toxicity, renal toxicity, bowel perforation/leak, fistula, bleeding, sepsis and abscess.