Trends in the indications for and short-term outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Eliza W. Beal, Ahmed Ahmed, Travis Grotz, Jennifer Leiting, Keith F. Fournier, Andrew J. Lee, Sean Dineen, Sophie Dessureault, Joel M. Baumgartner, Jula Veerapong, Callisia Clarke, Erin Strong, Shishir K. Maithel, Mohammad Y. Zaidi, Sameer Patel, Vikrom Dhar, Ryan Hendrix, Laura Lambert, Fabian Johnston, Nadege FackcheMustafa Raoof, Christopher LaRocca, Sean Ronnekleiv-Kelly, Courtney Pokrzywa, Timothy M. Pawlik, Sherif Abdel-Misih, Jordan M. Cloyd

Research output: Contribution to journalArticle

Abstract

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an increasingly utilized strategy for patients with peritoneal surface malignancies (PSM). Methods: The US HIPEC Collaborative was retrospectively reviewed to compare the indications and perioperative outcomes of patients who underwent CRS ± HIPEC between 2000 and 2012 (P1) versus 2013–2017 (P2). Results: Among 2,364 patients, 39% were from P1 and 61% from P2. The most common primary site was appendiceal (64%) while the median PCI was 13 and most patients had CCR 0 (60%) or 1 (25%). Over time, median estimated blood loss, need for transfusion, and length of hospital stay decreased. While the incidence of any (55% vs. 57%; p = 0.426) and Clavien III/IV complications did not change over time, there was a decrease in 90-day mortality (5% vs. 3%; p = 0.045). Conclusion: CRS-HIPEC is increasingly performed for PSM at high-volume centers. Despite improvements in some perioperative outcomes and a reduction in postoperative mortality, morbidity rates remain high.

Original languageEnglish (US)
JournalAmerican journal of surgery
DOIs
StateAccepted/In press - Jan 1 2019

Keywords

  • Cytoreductive surgery
  • Hyperthermic intraperitoneal chemotherapy

ASJC Scopus subject areas

  • Surgery

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