Use of hyperthermia versus normothermia during intraperitoneal chemoperfusion with oxaliplatin for colorectal peritoneal carcinomatosis: A propensity score matched analysis |
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| Affiliation: | 1. Department of Medical Oncology, Ghent University Hospital, Belgium;2. Department of GI Surgery, Ghent University Hospital, Cancer Research Institute Ghent (CRIG), Belgium;1. Croydon University Hospital, London, UK;2. Royal Marsden Hospital, London, UK;3. Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;4. Imperial College, London, UK;1. Klinik und Poliklinik für Chirurgie, Klinikum Rechts der Isar der Technischen Universität München, Germany;2. Visceral- und Thoraxchirurgie, Kreisklinikum Erding, Germany;1. Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK;2. Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Hills Road, Cambridge, UK;3. Department of Oesophago-Gastric Surgery, Manchester Royal Infirmary, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK;4. Department of Oesophago-Gastric Surgery, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK;1. Division of Thoracic Surgery, Italy;2. Division of Plastic and Reconstructive Surgery, Italy;3. Tumor Genomics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G.Venezian 1, 20133 Milan, Italy;4. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;5. Laboratory of Methodology for Clinical Research, Oncology Department, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Via Privata Giuseppe La Masa, 19, 20156 Milan, Italy |
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| Abstract: | ![]()
BackgroundHyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin (OX) is increasingly used in the treatment of colorectal peritoneal carcinomatosis (PC). However, the additional benefit of hyperthermia remains clinically unproven, while it may aggravate postoperative morbidity. Here, we report the correlation of perfusion temperature with postoperative morbidity during clinical HIPEC with OX.Patients and methodsPatients who underwent hyperthermic (41 °C, HT) or normothermic (37 °C, NT) chemoperfusion with OX for colorectal PC were identified from a prospectively kept database of HIPEC cases and matched for baseline characteristics using propensity score (PS) analysis. The groups were compared to assess the impact of perfusion temperature on morbidity. Morbidity was graded using the Clavien-Dindo (CD) classification and the Comprehensive Complication Index (CCI).ResultsOut of 612 patients, 146 patients met the inclusion criteria and from these patients, 45 HT patients were matched with 45 NT patients. Baseline variables were comparable between the PS matched groups. Overall mortality was 0.7% and major morbidity (CD ≥ 3) occurred in 35,6% of patients. There were no significant differences between the HT and NT cohorts in mortality, major morbidity (RR 1.33, 95% CI 0.71 to 2.49, p = 0.36), anastomotic leakage (13.8% versus 11.1%, p = 1.0), hemorrhagic complications, or systemic toxicity. A trend of increased wound infections was observed in the hyperthermia group (13.3% versus 4.4%, P = 0.27).ConclusionsCompared to NT, the use of HT during HIPEC with OX does not aggravate postoperative mortality or morbidity in a high-volume center. |
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| Keywords: | Intraperitoneal chemotherapy Peritoneal carcinomatosis Colorectal cancer Hyperthermia Morbidity Propensity score Neoplasm |
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