Hematological Alterations after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

• Published in: Journal of clinical medicine Vol. 12; no. 13; p. 4323
• Main Authors: Pintado, Maria Consuelo, Lasa Unzúe, Inmaculada, Gómez Sanz, Remedios, Diez Alonso, Manuel, Ortega, Miguel A, Álvarez de Mon, Melchor, Nevado Losada, Emilio, Gutierrez Calvo, Alberto
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.06.2023; MDPI
• Subjects: Anemia; Blood diseases; Blood products; Blood transfusions; Cancer; Care and treatment; Chemotherapy; Clinical medicine; Complications; Complications and side effects; Consent; Hematology; Hematuria; Hemoglobin; Hyperthermia; Hyperthermic intraperitoneal chemotherapy; Leukopenia; Mortality; Normal distribution; Ovarian cancer; Patients; Postoperative period; Regression analysis; Risk factors; Surgery; Spain; postoperative complications; cytoreduction; hyperthermic intraperitoneal; prognosis
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12134323

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have benefits for survival in some cancers with peritoneal metastasis. Hematologic toxicity described rate is 2 to 38%. Patients admitted to an intensive care unit (ICU) after CRS and HIPEC over 78 months. The data recorded were demographic characteristics, the severity of illness, complete blood samples, the type of cancer and extension, HIPEC drug and temperature, ICU and hospital stay and mortality, bleeding, and the need for transfusion of blood products. Of the 96 patients included, 77.1% presented hematological complications: 8.3% leukopenia (<4000/mm leucocytes), 66.7% anemia (hemoglobin < 10 mg/dL), and 22.9% coagulopathy (INR < 1.5, or/and aPTT < 45 s, or/and platelet count < 100,000/mm , or/and <100 mg/dL of serum fibrinogen). Leukopenia was higher in ovarian cancer or those treated with doxorubicin. Females with anemia, ovarian cancer, and those treated with cisplatin or doxorubicin had longer ICU stays. Bleeding complications were low-corrected in a conservative manner. The median ICU stay was 5 (4.0-5.0) days. The ICU mortality rate was 1.0%. In our study, 77.1% of patients treated with CRS and HIPEC developed hematological complications during the postoperative period; the majority of them were not severe and resolved spontaneously, without an effect on mortality or hospital stay.