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 Fackche; Mustafa Raoof; Christopher LaRocca; Sean Ronnekleiv-Kelly; Courtney Pokrzywa; Timothy M Pawlik; Sherif Abdel-Misih; Jordan M Cloyd

doi:10.1016/j.amjsurg.2019.09.017

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

Am J Surg. 2020 Mar;219(3):478-483. doi: 10.1016/j.amjsurg.2019.09.017. Epub 2019 Sep 19.

Authors

Eliza W Beal¹, Ahmed Ahmed¹, Travis Grotz², Jennifer Leiting², Keith F Fournier³, Andrew J Lee³, Sean Dineen⁴, Sophie Dessureault⁴, Joel M Baumgartner⁵, Jula Veerapong⁵, Callisia Clarke⁶, Erin Strong⁶, Shishir K Maithel⁷, Mohammad Y Zaidi⁷, Sameer Patel⁸, Vikrom Dhar⁸, Ryan Hendrix⁹, Laura Lambert⁹, Fabian Johnston¹⁰, Nadege Fackche¹⁰, Mustafa Raoof¹¹, Christopher LaRocca¹¹, Sean Ronnekleiv-Kelly¹², Courtney Pokrzywa¹², Timothy M Pawlik¹, Sherif Abdel-Misih¹, Jordan M Cloyd¹³

Affiliations

¹ The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
² Mayo Clinic, Rochester, MN, USA.
³ MD Anderson Cancer Center, Houston, TX, USA.
⁴ Moffitt Cancer Center, Tampa, FL, USA.
⁵ University of California San Diego, San Diego, CA, USA.
⁶ Medical College of Wisconsin, Milkwaukee, WI, USA.
⁷ Emory University, Atlanta, GA, USA.
⁸ University of Cincinnati, Cincinnati, OH, USA.
⁹ University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
¹⁰ Johns Hopkins University, Baltimore, MD, USA.
¹¹ City of Hope, Duarte, CA, USA.
¹² University of Wisconsin, Madison, WI, USA.
¹³ The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA. Electronic address: Jordan.Cloyd@osumc.edu.

PMID: 31558307
DOI: 10.1016/j.amjsurg.2019.09.017

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.

Keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy.

Publication types

Multicenter Study

MeSH terms

Aged
Cytoreduction Surgical Procedures / trends*
Female
Humans
Hyperthermia, Induced / trends*
Male
Middle Aged
Outcome and Process Assessment, Health Care*
Peritoneal Neoplasms / therapy*
Retrospective Studies
United States