Predictors of morbidity and mortality in patients submitted to cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for ovarian carcinomatosis: a multicenter study

Macrì, Antonio; Accarpio, Fabio; Arcoraci, Vincenzo; Casella, Francesco; Cian, Franco De; Iaco, Pierandrea De; Orsenigo, Elena; Roviello, Franco; Scambia, Giovanni; Saladino, Edoardo; Galati, Marica

doi:10.1515/pp-2020-0139

Cited by 3 publications

(3 citation statements)

References 44 publications

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“…transfusion requirement as independent predictors of major complications following CRS/HIPEC. 18,19 Data previously published from Waikato Hospital found significantly fewer blood transfusions than another Australian cohort, likely due to surgical haemostasis and judicious blood product use. 17 The effect of operative duration on major complication rate likely reflects both technical proficiency and pre-operative case selection.…”

Section: Discussionmentioning

confidence: 94%

“…Operative duration was an independent risk factor for major complications. Previous studies have identified PCI, blood loss, and transfusion requirement as independent predictors of major complications following CRS/HIPEC 18,19 . Data previously published from Waikato Hospital found significantly fewer blood transfusions than another Australian cohort, likely due to surgical haemostasis and judicious blood product use 17 .…”

Section: Discussionmentioning

confidence: 97%

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in New Zealand: peri‐operative outcomes and service development over a decade

Lim,

Qin,

et al. 2024

ANZ Journal of Surgery

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BackgroundCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard of care for selected cases of peritoneal surface malignancy. However, due to its morbidity and learning curve, it is only delivered in six centres in Australia and Aotearoa New Zealand (AoNZ). In this study, we report peri‐operative morbidity and mortality following CRS/HIPEC at Waikato and Braemar Hospitals, which have treated patients from all regions of AoNZ since 2008.MethodsWe retrospectively reviewed a database of all patients undergoing CRS and HIPEC from 01/01/2008 to 01/11/2020 at Waikato and Braemar Hospitals.ResultsTwo‐hundred and forty procedures were performed for 221 patients with a mean age of 55, including 22 (9.2%) re‐do procedures. One hundred and eighty‐six cases were European, 32 were Māori, and 16 were Pasifika. There were 152 pseudomyxoma peritonei, 39 colorectal adenocarcinomas, 29 appendiceal cancers, 8 ovarian cancers, 6 peritoneal mesothelioma, and 6 other tumour types. The median PCI was 16. HIPEC was administered to 196 out of 196 CC0/1 cases (100%) and 3 out of 44 CC2/3 cases (6.8%). Fifty‐six cases (23.3%) had at least one major complication. There were two mortalities (0.8%) within 30 days. The median length of stay was 11 days. Operative duration was identified as an independent risk factor for major complications. There was considerable variation in the number of referrals from different regions of AoNZ. Over time, a decline in major complication rate is seen with increased case volume.ConclusionThe Waikato region has achieved favourable short‐term outcomes following CRS/HIPEC.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 97%

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in New Zealand: peri‐operative outcomes and service development over a decade

Lim,

Qin,

et al. 2024

ANZ Journal of Surgery

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“…Macrì et al recorded the ECOG score and severe morbidity as predictors of 60-days survival [ 152 , 153 ].…”

Section: Treatment Of Ovarian Cancer Metastatic Peritoneal Surface Ma...mentioning

confidence: 99%

Cytoreductive Surgery (CRS) and HIPEC for Advanced Ovarian Cancer with Peritoneal Metastases: Italian PSM Oncoteam Evidence and Study Purposes

Marrelli

Ansaloni²,

Federici

et al. 2022

Cancers

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Ovarian cancer is the eighth most common neoplasm in women with a high mortality rate mainly due to a marked propensity for peritoneal spread directly at diagnosis, as well as tumor recurrence after radical surgical treatment. Treatments for peritoneal metastases have to be designed from a patient’s perspective and focus on meaningful measures of benefit. Hyperthermic intraperitoneal chemotherapy (HIPEC), a strategy combining maximal cytoreductive surgery with regional chemotherapy, has been proposed to treat advanced ovarian cancer. Preliminary results to date have shown promising results, with improved survival outcomes and tumor regression. As knowledge about the disease process increases, practice guidelines will continue to evolve. In this review, we have reported a broad overview of advanced ovarian cancer management, and an update of the current evidence. The future perspectives of the Italian Society of Surgical Oncology (SICO) are discussed conclusively.

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Nephrotoxicity Associated with Cytoreductive Surgery Combined with Cisplatin-Based Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Malignant Disease: A Systematic Review and Meta-Analysis

Grillo-Marín,

Antón-Rodríguez,

Prieto

et al. 2024

JCM

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Background: Cisplatin is employed in hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) for peritoneal surface malignancies (PSMs). The main concern regarding intraperitoneal cisplatin administration is nephrotoxicity. Numerous reports in this context are available. Our objective was to conduct a systematic review and meta-analysis to assess cisplatin-based HIPEC-related nephrotoxicity (CHRN). Methods: A systematic literature review on CHRN after CRS for the treatment of PSMs was performed. The literature search was carried out using Medline, Cochrane, and Embase. The last day of the search was 23 October 2023. PRISMA guidelines were used. A meta-analysis was then conducted. The main endpoint was the incidence of acute and chronic renal impairment after CHRN. Secondary endpoints included the potential impact of several clinical variables on the primary endpoint and a critical appraisal of the different renal impairment scales employed. Results: Our study included 26 articles with a total sample of 1473 patients. The incidence of acute kidney injury (AKI) was 18.6% (95% CI: 13.6–25%, range of true effects 3–59%). For chronic kidney disease, it was 7% (95% CI: 3–15.3%, range of true effects 1–53%). The variables that statistically influenced these results were the scale used to measure renal insufficiency, the use of nephroprotective agents, and the presence of pre-existing renal disease. Conclusions: The reported incidence of renal impairment following cisplatin-based HIPEC is highly variable. The incidence of renal failure obtained in this meta-analysis should be used as a reference for subsequent reports on this topic. Further prospective studies are warranted to establish optimal and standardized management.

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Predictors of morbidity and mortality in patients submitted to cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for ovarian carcinomatosis: a multicenter study

Cited by 3 publications

References 44 publications

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in New Zealand: peri‐operative outcomes and service development over a decade

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in New Zealand: peri‐operative outcomes and service development over a decade

Cytoreductive Surgery (CRS) and HIPEC for Advanced Ovarian Cancer with Peritoneal Metastases: Italian PSM Oncoteam Evidence and Study Purposes

Nephrotoxicity Associated with Cytoreductive Surgery Combined with Cisplatin-Based Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Malignant Disease: A Systematic Review and Meta-Analysis

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