Impact of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy on systemic toxicity

Shigeki Kusamura, Dario Baratti, Rami Younan, Barbara Laterza, Grazia Daniela Oliva, Pasqualina Costanzo, Myriam Favaro, Cecilia Gavazzi, Federica Grosso, Marcello Deraco

Research output: Contribution to journalArticle

Abstract

Introduction: The purpose of this study was to analyze the postoperative systemic toxicity and procedure-related mortality (PRM) of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal surface malignancies (PSMs). Patients and methods: A total of 242 (84 males/158 females) patients with PSM underwent 247 consecutive procedures. The mean age was 52 years (range 22-79). CRS was performed using peritonectomy procedures. The HIPEC technique through the closed abdomen was conducted with cisplatin (CDDP 25 mg/m2/l of perfusate)+mitomycin C (MMC 3.3 mg/m2/l perfusate) or CDDP (43 mg/l perfusate)+doxorubicin (Dx 15.25 mg/l perfusate) at 42.5°C. These dosages were reduced by 30% when the patient had received systemic chemotherapy before the CRS+HIPEC. Systemic toxicities were graded according to the NCI CTCAE v3 criteria. Results: G3-5 systemic toxicity rate was 11.7 % and adverse events were bone marrow suppression, 13; nephrotoxicity, 14; neutropenic infection, 2 and pulmonary toxicity, 1. Independent risk factors for G3-5 systemic toxicity after multivariate analysis were a dose of CDDP for HIPEC of 240 mg or more (OR 2.78, CI 95% 1.20-6.45) and CDDP+Dx schedule for HIPEC (OR 2.36, CI 95% 1.02-5.45). PRM was 1.2%. Conclusions: CRS+HIPEC presented acceptable systemic toxicity and PRM rates. Independent risk factors for systemic toxicity were the CDDP+Dx schedule and CDDP dose for HIPEC.

Original languageEnglish
Pages (from-to)2550-2558
Number of pages9
JournalAnnals of Surgical Oncology
Volume14
Issue number9
DOIs
Publication statusPublished - Sep 2007

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Keywords

  • Hyperthermic Intraperitoneal Chemotherapy
  • Peritonectomy
  • Toxicity

ASJC Scopus subject areas

  • Surgery
  • Oncology

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