Hyperthermic intraperitoneal chemotherapy does not increase risk of major complication or failure to rescue in cytoreductive surgery.


Journal

Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643

Informations de publication

Date de publication:
Sep 2022
Historique:
revised: 27 04 2022
received: 04 01 2022
accepted: 07 05 2022
pubmed: 8 6 2022
medline: 13 8 2022
entrez: 7 6 2022
Statut: ppublish

Résumé

Failure to rescue (FTR) is defined as death after a major complication. We evaluated FTR after cytoreductive surgery (CRS) with and without hyperthermic intraperitoneal chemotherapy (HIPEC). The ACS NSQIP database 2005-2018 was reviewed for all cases of CRS. Propensity score matching was used to compare outcomes between those undergoing CRS alone and those undergoing CRS/HIPEC. Patients were matched on age, sex, ascites, diabetes, hypertension and resection of liver, pancreas, colon/rectum, diaphragm, stomach, small bowel, and/or spleen. Thirty nine thousand one hundred and twenty-six patients underwent CRS; 38,387 underwent CRS alone; 739 underwent CRS/HIPEC. After matching there were 726 patients in each arm. Patients undergoing CRS/HIPEC had higher risk of reintubation (25 [3.4%] vs. 13 [1.8%] p = 0.049), urinary tract infection UTI (44 [6.1%] vs. 25 [3.4%] p = 0.019) and sepsis (73 [10.1%] vs. 44 [6.1%] p = 0.005). Patients in the CRS arm required more transfusions (229 [31.5%] vs. 176 [24.2%] p = 0.002). There was no significant difference in FTR between the CRS and CRS/HIPEC groups (11 [4.0%] vs. 6 [2.3%] p = 0.258), nor in the pooled incidence of major complications (275 [37.9%] vs. 262 [36.1%] p = 0.48). CRS/HIPEC is associated with increased rates of reintubation, UTI, and sepsis while CRS alone was associated with increased transfusion. However, the addition HIPEC to CRS did not increase the risk of pooled major complication or FTR.

Identifiants

pubmed: 35668645
doi: 10.1002/jso.26969
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

781-786

Informations de copyright

© 2022 Wiley Periodicals LLC.

Références

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Auteurs

Rebekah C Macfie (RC)

The Mount Sinai Hospital, New York, New York, USA.

Da Eun Cha (DE)

The Mount Sinai Hospital, New York, New York, USA.

Elizabeth Gleeson (E)

The Mount Sinai Hospital, New York, New York, USA.

Allen Yu (A)

The Mount Sinai Hospital, New York, New York, USA.

Noah Cohen (N)

The Mount Sinai Hospital, New York, New York, USA.

Umut Sarpel (U)

The Mount Sinai Hospital, New York, New York, USA.

Benjamin Golas (B)

The Mount Sinai Hospital, New York, New York, USA.

Spiros Hiotis (S)

The Mount Sinai Hospital, New York, New York, USA.

Daniel Labow (D)

The Mount Sinai Hospital, New York, New York, USA.

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