scholarly journals Outcomes of Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Patients Older Than 70 Years; Survival Benefit at Considerable Morbidity and Mortality

2013 ◽  
Vol 20 (11) ◽  
pp. 3497-3503 ◽  
Author(s):  
Konstantinos I. Votanopoulos ◽  
Naeem A. Newman ◽  
Greg Russell ◽  
Chukwuemeka Ihemelandu ◽  
Perry Shen ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Survival Benefit ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Morbidity And Mortality ◽  
Considerable Morbidity

Early Postoperative Extubation is Associated with Shorter Hospitalization and Improved Short-Term Survival in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

2022 ◽  
pp. 000313482110505
Author(s):  
Leah E. Hendrick ◽  
Xin Huang ◽  
William P. Hewgley ◽  
Luke Douthitt ◽  
Paxton V. Dickson ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Survival Benefit ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Regression Coefficient ◽  
Hospital Length Of Stay ◽  
Term Survival ◽  
Factors Associated ◽  
Kaplan Meier ◽  
Early Survival

Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is associated with significant operative time, hospital resources, and morbidity. We examine factors associated with hospital length of stay (LOS) and early overall survival (OS) after CRS/HIPEC. Materials and Methods Patients who underwent CRS/HIPEC were evaluated for factors associated with LOS. Institutional learning curve influence was addressed by comparing early vs late cohorts. Variables with P < .200 after univariate analysis were considered for inclusion in multivariate linear regression modeling. Independent factors associated with OS were evaluated using the Kaplan-Meier method. Results Seventy patients underwent CRS/HIPEC (mean age 52.3 years, 64.3% female, and 68.6% Caucasian). Presence of any surgical complication was found in 26 (37.1%), 28 (40%) remained intubated postoperatively, and the mean Peritoneal Carcinomatosis Index (PCI) score was 14.4 ([Formula: see text]10.4). Mean intensive care unit and hospital LOS were 2.9 days ([Formula: see text]2.3) and 9.6 days ([Formula: see text]3.6), respectively. After adjusting for covariates, only shorter time to postoperative ambulation (regression coefficient .92, P = .001) and early extubation (regression coefficient −1.90, P = .018) were associated with decreased hospital LOS on multivariate analysis. Immediate postoperative extubation conferred an independent early survival benefit on Kaplan-Meier analysis (mean OS 714.8 vs 473.4 days, P = .010). There was no difference in hospital LOS or OS between early and late cohorts. Conclusion Early postoperative extubation and shorter time to ambulation are associated with decreased hospital LOS. Moreover, CRS/HIPEC patients extubated immediately postoperatively have an early survival benefit. Every effort should be made to achieve early postoperative extubation and mobilization in CRS/HIPEC patients.

scholarly journals Morbidity and Mortality Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy at a Single Institution in Japan

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Akiyoshi Mizumoto ◽  
Emel Canbay ◽  
Masamitsu Hirano ◽  
Nobuyuki Takao ◽  
Takayuki Matsuda ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Single Institution ◽  
Crs And Hipec

Background. Even though cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are associated with a high morbidity and mortality rates, it has been reported that CRS and HIPEC improved survival of selected patients with peritoneal carcinomatosis. We aimed to report morbidity and mortality results of CRS and HIPEC from a single institution in Japan.Methods and Results. Total of 284 procedures of CRS were performed on patients with pseudomyxoma peritonei, peritoneal carcinomatosis (PC) from colon cancer and gastric cancer between 2007 and 2011 in our institution. The morbidity rate was 49% of all procedure, and grades I/II and grades III/IV complications were 28% and 17%, respectively. Most frequent complication was surgical site infections including intraabdominal abscess. The mortality rate was 3.5%, and reoperation was needed in 11% of all procedures. Univariate and multivariate analysis showed peritoneal carcinomatosis index (PCI) greater than 20 was the only significant factor for occurrence of postoperative complications (P<0.01). In contrast, HIPEC significantly reduced postoperative complications (P<0.05).Conclusions. The morbidity and mortality rates of our institution are comparable with previous reports that are in acceptable rates. Optimal patient selection such as patients with PCI less than 20 seems to be of paramount importance to CRS and HIPEC.

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

2020 ◽  
Vol 6 (1) ◽  
pp. 21-30
Author(s):  
Antonio Macrì ◽  
Fabio Accarpio ◽  
Vincenzo Arcoraci ◽  
Francesco Casella ◽  
Franco De Cian ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Multicenter Study ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Multivariate Logistic Regression Analysis ◽  
Morbidity And Mortality ◽  
Blood Transfusions ◽  
Multivariate Logistic Regression

Abstract Objectives The aim of this retrospective study is to assess the incidence of morbidity and mortality related to cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and to evaluate their predictors, in patients with peritoneal metastasis of ovarian origin. Methods A retrospective multicenter study was carried out investigating results from eight Italian institutions. A total of 276 patients met inclusion criteria. Predictors of morbidity and mortality were evaluated with univariate and multivariate analysis. Results Overall morbidity was 71.4%, and severe complications occurred in 23.9% of the sample; 60-day mortality was 4.3%. According to univariate logistic regression models, grade 3–4 morbidity was related to Peritoneal Cancer Index (PCI) (OR 1.06; 95% CI 1.02–1.09; p<0.001), number of intraoperative blood transfusions (OR 1.21; 95% CI 1.10–1.34; p<0.001), Completeness of Cytoreduction (CC) score (OR 1.68; 95% CI 1.16–2.44; p=0.006) and number of anastomoses (OR 1.32; 95% CI 1.00–1.73; p=0.046). However, at the multivariate logistic regression analysis, only the number of intraoperative blood transfusions (OR 1.17; 95% CI 1.5–1.30; p=0.004) and PCI (OR 1.04; 95% CI 1.01–1.08; p=0.010) resulted as key predictors of severe morbidity. Furthermore, using multivariate logistic regression model, ECOG score (OR 2.45; 95% CI 1.21–4.93; p=0.012) and the number of severe complications (OR 2.16; 95% CI 1.03–4.52; p=0.042) were recorded as predictors of exitus within 60 days. Conclusions The combination of CRS and HIPEC for treating peritoneal metastasis of ovarian origin has acceptable morbidity and mortality and, therefore, it can be considered as an option in selected patients.

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