Successful pregnancy following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal malignancies

Background: Cytoreductive surgery (CRS) with Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) has become a successful, potentially curative, treatment option for peritoneal surface malignancies (PSM). CRS and HIPEC (CRS/HIPEC) are performed with curative intent for several intra-peritoneal pathologies. An increasing number of patients with PSM are diagnosed at a relatively young age. Given the long-term survival in some patients following CRS/HIPEC, the reproductive health of patients in this age group requires consideration. Methods: Surgical oncology teams participating in the Peritoneal Surface Oncology Group International (PSOGI) were offered the opportunity to share their experience and data regarding the obstetric outcomes of female patients who had undergone CRS/HIPEC. Results: Nineteen (19) patients were reported to have had a baby following CRS/HIPEC. The median interval between CRS/HIPEC and pregnancy was 37 months, and 16 patients had a normal vaginal delivery. All of the newborns were healthy, without medical issues attributed to CRS or HIPEC chemotherapy. Overall, 89 % of mothers had no evidence of disease at their last follow-up. Conclusion: Successful pregnancies following CRS/HIPEC are seldom reported in the literature, and fertility preservation is not uniformly discussed. Data from this international collaboration highlights the reproductive potential in patients with PSM following CRS/HIPEC and the value of pre-operative obstetric and fertility advice and management to achieve that end.