Morbidity following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases with or without early postoperative intraperitoneal chemotherapy: A propensity score matched study |
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| Institution: | 1. Department of Surgical Sciences, Department of Colorectal Surgery, Uppsala University, 752 36, Uppsala, Sweden;2. Department of Surgical Sciences, Department of Colorectal Surgery, Uppsala University Hospital, S-751 85, Uppsala, Sweden;1. Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, UK;2. Queen''s University Belfast, University Road, Belfast, Northern Ireland, UK;1. George Davies Research Fellowship, St Mark''s Hospital, UK;2. Department of Surgery, St Mark''s Hospital, Watford Road, Harrow, HA1 3UJ, UK;3. Department of Surgery and Cancer, Imperial College London, Paddington, London, W2 1NY, UK;1. Department of Gynaecological Oncology, The Pan-Birmingham Gynaecological Cancer Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK;2. Department of Gynaecology, Worcestershire Acute Hospitals NHS Trust, Worcester, UK;3. Institute of Cancer and Genomic Sciences, University of Birmingham, UK;1. Surgery Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland;2. Department of Surgery, Mehiläinen Länsi-Pohja, Länsi-Pohja Central Hospital, Kemi, Finland;3. Upper Gastointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden |
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| Abstract: | BackgroundCombining hyperthermic intraperitoneal chemotherapy (HIPEC) treatment with early postoperative intraperitoneal chemotherapy (EPIC) may increase postoperative morbidity. This study aims to investigate postoperative morbidity after HIPEC+EPIC compared with HIPEC alone in patients with peritoneal metastases (PM).Materials and methodsThis is a retrospective propensity score matched cohort study. All patients undergoing PM treatment at Uppsala University Hospital between February 2004 and December 2014 were included. Propensity score matching with a 1:1 ratio was performed using sex, primary tumor site, preoperative chemotherapy, peritoneal cancer index, completeness of cytoreduction score, and HIPEC regimen. Length of hospital stay, morbidity, reoperation rate, and readmission rate within 6 months were selected as endpoints.ResultsA total of 390 consecutive patients were divided in two arms: HIPEC+EPIC (n = 115) and HIPEC alone (n = 275). The propensity score matching (n = 190) was successful with balanced covariates: 95 patients/arm. The length of stay (LOS) was longer in the HIPEC + EPIC group in the total cohort (30 vs 24 days, p < 0.001), with a trend towards significance in the propensity matched group (29 vs 25 days, p = 0.062). No other differences in endpoints were found.ConclusionHIPEC+EPIC is associated with a prolonged hospital stay, but with no statistically significant relevant increase in postoperative morbidity, reoperation rate or incidence of readmission. |
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| Keywords: | HIPEC Early postoperative intraperitoneal chemotherapy (EPIC) Peritoneal metastasis (PM) Morbidity Propensity score matching (PSM) |
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