Abstract
Introduction: Hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming a standard therapy in the treatment of peritoneal carcinomatosis (PC). Compared to systemic chemotherapy, HIPEC improves survival in patients with PC. This therapy has high morbidity rates (up to 41%). In vitro it has been demonstrated that hyperthermia has a toxic effect on malign cells. However, hyperthermia also affects normal tissue. To my knowledge, any additional effect of hyperthermia combined with chemotherapy has never been demonstrated in a clinical setting. In this study, the effects of hyperthermia on outcome and survival were analyzed.Methods: Patients with PC from any origin who were treated with HIPEC were included in this retrospective, non-randomized study. Data on patient characteristics, tumor characteristics, features of the surgery and postoperative complications were extracted from patient files. Models predicting time to removal of nasogastric tube (TRNT), post-operative major complications, the occurrence of anastomotic leaks and post-operative survival were built, using negative binomial regression, logistic regression or Cox proportional hazards regression as appropriate.Results: 138 patients treated with HIPEC were included. Maximal temperature during the operation was not statistically significantly associated with anastomotic leaks or post-operative major complications. Maximal temperature during the operation was negatively associated with post-operative survival (P=0.01).Conclusion: The results suggest that hyperthermia may negatively affect survival in patients who are treated with HIPEC for PC of various origins. This study has the classical limitations of a retrospective study. Therefore, randomized trials are required to confirm the results.
Highlights
Hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming a standard therapy in the treatment of peritoneal carcinomatosis (PC)
HIPEC is combined with cytoreductive surgery, where the tumor mass is decreased as much as possible before the administration of chemotherapy
The aim of this study was to identify the impact of the temperature of the perfusate on post-operative ileus, major post-operative complications, the occurrence of anastomotic leaks and post-operative survival
Summary
Hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming a standard therapy in the treatment of peritoneal carcinomatosis (PC). HIPEC improves survival in patients with PC. This therapy has high morbidity rates (up to 41%). Methods: Patients with PC from any origin who were treated with HIPEC were included in this retrospective, non-randomized study. Conclusion: The results suggest that hyperthermia may negatively affect survival in patients who are treated with HIPEC for PC of various origins. When treated with hyperthermic intraperitoneal chemotherapy (HIPEC), survival rates of patients with PC of ovarian and colorectal origin increased to 66 and 30 months, respectively[2,4]. HIPEC is combined with cytoreductive surgery, where the tumor mass is decreased as much as possible before the administration of chemotherapy
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