Trends in the indications for and short-term outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

• Published in: The American journal of surgery Vol. 219; no. 3; pp. 478 - 483
• Main Authors: Beal, Eliza W., Ahmed, Ahmed, Grotz, Travis, Leiting, Jennifer, Fournier, Keith F., Lee, Andrew J., Dineen, Sean, Dessureault, Sophie, Baumgartner, Joel M., Veerapong, Jula, Clarke, Callisia, Strong, Erin, Maithel, Shishir K., Zaidi, Mohammad Y., Patel, Sameer, Dhar, Vikrom, Hendrix, Ryan, Lambert, Laura, Johnston, Fabian, Fackche, Nadege, Raoof, Mustafa, LaRocca, Christopher, Ronnekleiv-Kelly, Sean, Pokrzywa, Courtney, Pawlik, Timothy M., Abdel-Misih, Sherif, Cloyd, Jordan M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2020; Elsevier Limited
• Subjects: Aged; Blood transfusion; Cancer; Chemotherapy; Collaboration; Complications; Cytoreduction Surgical Procedures - trends; Cytoreductive surgery; Data collection; Female; Humans; Hyperthermia, Induced - trends; Hyperthermic intraperitoneal chemotherapy; Male; Mesothelioma; Middle Aged; Morbidity; Mortality; Ostomy; Outcome and Process Assessment, Health Care; Patients; Peritoneal Neoplasms - therapy; Peritoneum; Recovery (Medical); Retrospective Studies; Short term; Surgery; Transfusion; Trends; United States; United States; United States > US; Hyperthermic intraperitoneal chemotherapy; Cytoreductive surgery
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2019.09.017

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an increasingly utilized strategy for patients with peritoneal surface malignancies (PSM). The US HIPEC Collaborative was retrospectively reviewed to compare the indications and perioperative outcomes of patients who underwent CRS ± HIPEC between 2000 and 2012 (P1) versus 2013–2017 (P2). Among 2,364 patients, 39% were from P1 and 61% from P2. The most common primary site was appendiceal (64%) while the median PCI was 13 and most patients had CCR 0 (60%) or 1 (25%). Over time, median estimated blood loss, need for transfusion, and length of hospital stay decreased. While the incidence of any (55% vs. 57%; p = 0.426) and Clavien III/IV complications did not change over time, there was a decrease in 90-day mortality (5% vs. 3%; p = 0.045). CRS-HIPEC is increasingly performed for PSM at high-volume centers. Despite improvements in some perioperative outcomes and a reduction in postoperative mortality, morbidity rates remain high. •Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an increasingly utilized strategy.•The current study examines indications and perioperative outcomes of patients undergoing CRS ± HIPEC over time.•Over time median estimated blood loss, need for transfusion, and length of hospital stay decreased.•While the incidence of any complication did not change over time, there was a decrease in 90-day mortality.•Despite improvements in some perioperative outcomes and a reduction in postoperative mortality, morbidity rates remain high.