Complications and Toxicities After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

• Published in: Annals of surgical oncology 2013-04, Vol.20 (4), p.1082-1087
• Main Authors: Canda, Aras Emre, Sokmen, Selman, Terzi, Cem, Arslan, Cigdem, Oztop, Ilhan, Karabulut, Bulent, Ozzeybek, Deniz, Sarioglu, Sulen, Fuzun, Mehmet
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Chemotherapy, Adjuvant; Chemotherapy, Cancer, Regional Perfusion - adverse effects; Combined Modality Therapy; Female; Follow-Up Studies; Hematologic Diseases - diagnosis; Hematologic Diseases - etiology; Humans; Hyperthermia, Induced - adverse effects; Kidney Diseases - diagnosis; Kidney Diseases - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - blood; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - mortality; Neoplasms - mortality; Neoplasms - pathology; Neoplasms - therapy; Oncology; Postoperative Complications; Prognosis; Prospective Studies; Regional Cancer Therapies; Surgery; Surgical Oncology; Survival Rate; Young Adult
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-012-2853-x

Introduction The purpose of our study was to evaluate the perioperative complications, toxicity, mortality rates after cytoreductive surgery (CRS), and effects of hyperthermic intraperitoneal chemotherapy (HIPEC) used in the treatment of peritoneal surface malignancies. Methods Between September 2007 and March 2012, we performed 118 CRS and HIPEC with the closed abdominal technique on 115 patients with peritoneal carcinomatosis (PC). Systemic toxicities were graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria and were analyzed from a prospectively collected database. Results The mean age of patients was 53.4 (range, 20–82) years; 76.3 % were female. PC was synchronous to primary cancer in 53.4 % of patients, metachronous in 41.5 %, and recurrent in 5.1 % of the patients. PCI was ≥15 in 53.4 % of the patients, and CC-0 cytoreduction was achieved in 68.5 % of the patients. Perioperative mortality was observed in 9 (7.6 %) patients. A total of 98 complications were observed in 46 (39.0 %) patients, and 4 patients underwent 6 reoperations for perioperative surgical complications. We observed toxicity in 25.4 % of the patients, nephrotoxicity in 18.6 %, and hematological toxicity in 13.6 % of patients. No significant difference was observed among age, gender, PCI and CC scores, origin of the primary tumor, and occurrence of toxicity and surgical complications. Prolonged operation times resulted in higher complication and/or toxicity rates ( P