Comparison of open and closed hyperthermic intraperitoneal chemotherapy: Results from the United States hyperthermic intraperitoneal chemotherapy collaborative

Jennifer L. Leiting, Jordan M. Cloyd, Ahmed Ahmed, Keith Fournier, Andrew J. Lee, Sophie Dessureault, Seth Felder, Jula Veerapong, Joel M. Baumgartner, Callisia Clarke, Harveshp Mogal, Charles A. Staley, Mohammad Y. Zaidi, Sameer H. Patel, Syed A. Ahmad, Ryan J. Hendrix, Laura Lambert, Daniel E. Abbott, Courtney Pokrzywa, Mustafa RaoofChristopher J. LaRocca, Fabian M. Johnston, Jonathan Greer, Travis E. Grotz

Research output: Contribution to journalArticle

Abstract

BACKGROUND Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis can be performed in two ways: Open or closed abdominal technique. AIM To evaluate the impact of HIPEC method on post-operative and long-term survival outcomes. METHODS Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative database. Post-operative, recurrence, and overall survival outcomes were compared between those who received open vs closed HIPEC. RESULTS Of the 1812 patients undergoing curative-intent CRS and HIPEC, 372 (21%) patients underwent open HIPEC and 1440 (79%) underwent closed HIPEC. There was no difference in re-operation or severe complications between the two groups. Closed HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d mortalities. On multi-variable analysis, closed HIPEC technique was not a significant predictor for overall survival (hazards ratio: 0.75, 95% confidence interval: 0.51-1.10, P = 0.14) or recurrence-free survival (hazards ratio: 1.39, 95% confidence interval: 1.00-1.93, P = 0.05) in the entire cohort. These findings remained consistent in the appendiceal and the colorectal subgroups. CONCLUSION In this multi-institutional analysis, the HIPEC method was not independently associated with relevant post-operative or long-term outcomes. HIPEC technique may be left to the discretion of the operating surgeon.

Original languageEnglish (US)
Pages (from-to)756-767
Number of pages12
JournalWorld Journal of Gastrointestinal Oncology
Volume12
Issue number7
DOIs
StatePublished - Jul 15 2020

Keywords

  • Cytoreductive surgery
  • Mucinous appendiceal carcinoma
  • Multi-institutional

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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