No impact on long-term survival of prolonged ICU stay and re-admission for patients undergoing cytoreductive surgery with HIPEC

• Published in: European journal of surgical oncology 2016-06, Vol.42 (6), p.855-860
• Main Authors: Wallet, F., Dr, Maucort Boulch, D., Dr, Malfroy, S., Dr, Ledochowski, S., Dr, Bernet, C., Dr, Kepenekian, V., Dr, Passot, G., Dr, Vassal, O., Dr, Piriou, V., Pr, Glehen, O., Pr, Friggeri, A., Dr
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bacteriology; Chemotherapy, Adjuvant; Chemotherapy, Cancer, Regional Perfusion; Combined Modality Therapy; Cytoreduction Surgical Procedures; Cytoreductive surgery; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; HIPEC; Humans; Hyperthermia, Induced; Immunology; Intensive care unit; Intensive Care Units; Life Sciences; Long term outcome; Microbiology and Parasitology; Neoplasm Staging; Peritoneal Neoplasms; Prognosis; Surgery; Survival Rate; Virology
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2016.03.004

Abstract Background Cytoreductive surgery (CRS) and Hyperthermic intraperitoneal chemotherapy (HIPEC) are promising new approaches of peritoneal metastases. However these surgical procedures are associated with a high morbidity rate thus intensive care (IC) management following serious complications may be warranted for these patients. The impact of the prolonged IC stay or re-admission on long-term survival remains unknown. Methods We retrospectively analysed 122 consecutive HIPEC procedures over a one year period (2010-2011) in a single academic hospital. We analysed complications that would lead to prolonged stay or re-admission into ICU and analysed long term follow-up in patients whether they required intensive care (ICU group) or not (Control group). Results ICU group represented 26.2% of the cohort mainly due to septic or haemorrhagic shock. Among them acute kidney injury and respiratory failure were present in 50% and 47% respectively. Cohort overall mortality rate was of 5.7 %. Patients were followed for 4 years and survival analysis was performed adjusting for main confounding factors in a Cox survival model. Survival was not different between groups, with a median survival of 38 months [32;44] vs. 33 months [26;39] in the ICU group and Control group respectively. Conclusion Prolonged stay or re-admission into ICU does not seem to statistically impact long term prognosis of patients undergoing CRS with HIPEC.