The Safety of Iterative Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis: A High Volume Center Prospectively Maintained Database Analysis

Bekhor, Eliahu Y.; Carr, John Alfred; Hofstedt, Margaret; Sullivan, Brianne; Solomon, Daniel; Leigh, Natasha; Bolton, Nathan; Golas, Benjamin; Sarpel, Umut; Labow, Daniel M.; Magge, Deepa

doi:10.1245/s10434-019-08141-w

Cited by 17 publications

(7 citation statements)

References 39 publications

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“…It is presumed that repeated procedures are associated with a major late complication rate that is twice as high. 40 The AI rate in the study by Bekhor and coworkers was 8% for primary CRS and HIPEC and 14% for repeated procedures. 40 The stoma creation rate was 17%, which is in line with other large retrospective analyses from the USA and Israel.…”

Section: Discussionmentioning

confidence: 90%

“…40 The AI rate in the study by Bekhor and coworkers was 8% for primary CRS and HIPEC and 14% for repeated procedures. 40 The stoma creation rate was 17%, which is in line with other large retrospective analyses from the USA and Israel. 41,42 Doud and colleagues showed that, in their cohort, only 26% of potentially reversible stomata were indeed reversed.…”

Section: Discussionmentioning

confidence: 90%

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In-Hospital Mortality and Complication Rates According to Health Insurance Data in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies in Germany

et al. 2020

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Background Morbidity and in-hospital mortality rates of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Germany are not known. Methods From 2009 to 2018 all patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Germany were retrospectively analyzed regarding morbidity and in-hospital mortality rates according to nationwide hospital billing data based on diagnosis-related groups (DRG). The “failure to rescue” (FTR) index, characterizing patients who died after severe but potentially manageable complications, was calculated. Results In total, 8463 patients were included and analyzed. Female sex predominated (1.5:1). Colonic origin of peritoneal metastasis was highest throughout all years, reaching its highest level in 2017 (55%; n = 563) and its lowest level in 2012 (40%; n = 349). Median length of hospital stay reached its maximum in 2017 at 23.9 days and its minimum in 2010 at 22.0 days. Analysis of the total FTR index showed a noticeable improvement over the years, reaching its lowest values in 2017 (9.8%) and 2018 (8.8%). The FTR index for sepsis, peritonitis, and pulmonary complications significantly improved over time. Of the 8463 included patients, 290 died during hospital stay, reflecting an in-hospital mortality rate of 3.4%. Conclusion In-hospital mortality after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is reasonably low compared with other surgical procedures. The improvement in the FTR index reflects efforts to centralize treatment at specialized high-volume centers.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 90%

In-Hospital Mortality and Complication Rates According to Health Insurance Data in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies in Germany

et al. 2020

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“…As a developing technology, the safety of HIPEC has been con rmed by many researchers in terms of short-term postoperative complications [8, [15][16][17][18][19]. Overall, HIPEC for gastric cancer did not increase the incidence of complications in patients with gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

Hyperthermic intraperitoneal chemotherapy for patients with gastric cancer based on laboratory tests is safe: a single Chinese center analysis

Zheng

Sun³

et al. 2022

Preprint

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Purpose: This study evaluated the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer diagnosed from laboratory tests. Methods: The clinical and pathological data of 63 patients with gastric cancer who underwent HIPEC in 2017–2021 were prospectively recorded. Fifty-five patients underwent cytoreductive surgery + HIPEC, and eight patients received HIPEC alone. The factors associated with HIPEC safety and efficacy were analyzed. The primary endpoint was overall survival.Results: The average patient age was 54.84 years and 68.3% of patients were male. Moreover, 79.4% of patients had a peritoneal carcinoma index (PCI) score of ≤7 and 61.9% had a completeness of cytoreduction score of 0. Because of peritoneal metastasis, 29 patients (46.03%) were classified as stage IV. Laboratory tests showed no differences in pre-HIPEC blood test results compared to post-HIPEC results after removing the effects of surgery. HIPEC treatment did not cause obvious liver or kidney damage. Serum calcium levels decreased significantly after HIPEC (P=0.0018). The Karnofsky performance status (KPS) score correlated with the patient’s physical function and improved after HIPEC (P=0.0045). In coagulation tests, FDP (P<0.0001) and D-dimer (P<0.0001) levels increased significantly and CA242 (P=0.0159), CA724 (P<0.0001), and CEA (P<0.0014) levels decreased significantly after HIPEC. Completeness of cytoreduction score was an independent prognostic factor. HIPEC did not show a survival benefit in patients with gastric cancer (P=0.5505).Conclusion: HIPEC is a safe treatment for patients with gastric cancer with peritoneal metastasis based on the laboratory tests. Its efficacy in terms of overall survival requires confirmation.

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“…In patients with peritoneal recurrence, repeat CRS and HIPEC is a safe treatment modality that offers survival advantages [ 29 , 30 ]. In a study of 377 patients treated with CRS and HIPEC at a single institution, there were no differences in recurrence rate, disease-free survival or overall survival at a median follow-up of 24 months between patients who underwent single versus iterative CRS and HIPEC for MPM [ 29 ]. While 90-day major morbidity and 90-day mortality were similar between the two groups, the iterative CRS and HIPEC group had significant higher rates of late complications, 40% versus 18%, respectively.…”

Section: Surgical Treatment Of Mpmmentioning

confidence: 99%

Treatment of Patients with Malignant Peritoneal Mesothelioma

Kennedy

Alexander

2022

JCM

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Malignant peritoneal mesothelioma is a rare malignancy arising from the serosa of the peritoneal cavity. It is diagnosed based on suspicious findings on cross sectional imaging and a tissue biopsy showing confirmatory histologic and immunohistochemical features. The disease is hallmarked by its propensity to progress mainly in the peritoneal cavity. In selected patients, surgical cytoreduction and hyperthermic intra-operative peritoneal chemotherapy has become the initial preferred treatment and is associated with provide prolonged in many patients. Systemic chemotherapy using a couplet of cisplatin or gemcitabine with pemetrexed has modest response rates and duration of response. Expression of PD-L1 has been demonstrated in peritoneal mesothelioma tumors and there has been significant interest in the use of check point blockade targeted against PD-L1 in this clinical setting. Future clinical research using a combination of check point blockade with surgical cytoreduction is a high clinical priority.

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The Safety of Iterative Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis: A High Volume Center Prospectively Maintained Database Analysis

Cited by 17 publications

References 39 publications

In-Hospital Mortality and Complication Rates According to Health Insurance Data in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies in Germany

In-Hospital Mortality and Complication Rates According to Health Insurance Data in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies in Germany

Hyperthermic intraperitoneal chemotherapy for patients with gastric cancer based on laboratory tests is safe: a single Chinese center analysis

Treatment of Patients with Malignant Peritoneal Mesothelioma

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