The Role of Neoadjuvant and Adjuvant Systemic Chemotherapy with Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Colorectal Peritoneal Metastases: A Systematic Review

2017 ◽  
Vol 24 (3) ◽  
pp. 705-720 ◽  
Author(s):  
Kathryn Waite ◽  
Haney Youssef
Keyword(s):  
Systematic Review ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Systemic Chemotherapy ◽  
Peritoneal Metastases ◽  
Heated Intraperitoneal Chemotherapy

scholarly journals Neutropenia and thrombocytopenia after cytoreductive surgery and heated intraperitoneal chemotherapy

2017 ◽  
Vol 2 (3) ◽  
pp. 137-141 ◽  
Author(s):  
Ben Finlay ◽  
Timothy Price ◽  
Peter Hewett
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Systemic Chemotherapy ◽  
Haematological Toxicity ◽  
Subsequent Growth ◽  
Single Centre ◽  
Post Procedure ◽  
Heated Intraperitoneal Chemotherapy ◽  
Crs And Hipec ◽  
Grade 3

AbstractBackgroundNeutropenia and thrombocytopenia are well-recognised complications of systemic chemotherapy. In cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC), the interplay between surgical factors and systemic toxicity of chemotherapeutics must be considered when considering post-operative haematological outcomes. We sought to quantify the incidence of these events in cytoreductive surgery and HIPEC at our institution.MethodsWe conducted a single centre, a retrospective cohort study of 50 consecutive patients who underwent cytoreductive surgery and HIPEC from 2002 to 2015. Routine haematological data were analysed and complications classified according to CTCAE 4.0. Subgroup analysis was undertaken to compare those who received or not perioperative systemic chemotherapy.ResultsThe rate of all-grade post-procedure neutropenia was 4 % (n=2/50); one grade 1, and one grade 4 neutropenia. The patient with grade 4 neutropenia died day 57 post-operatively, despite subsequent growth factor support. Eight percent (n=4/50) of patients had thrombocytopenia preoperatively. The overall rate of post-procedure thrombocytopenia was 46 % with grade 3–4 thrombocytopenia of 4 %. If not present preoperatively, thrombocytopenia onset was on day 1 or 2 post-operatively, with a median duration of 3 days.ConclusionsIntraperitoneal delivery of chemotherapy as HIPEC can cause haematological toxicity with potentially fatal outcomes. However, the incidence of neutropenia and thrombocytopenia after CRS and HIPEC is low.

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