Thoracic complications in patients undergoing intraperitoneal heated chemotherapy with mitomycin following cytoreductive surgery.
BACKGROUND
The purpose of this study was to determine the incidence and severity of thoracic reactions in patients undergoing intraperitoneal heated chemotherapy (IPHC).


METHODS
Forty-two patients who had intraperitoneal disseminated malignancies were treated with cytoreductive surgery (CS) and IPHC. The primary malignancies included carcinoma of the colon (n = 17), stomach (n = 6), appendix (n = 6), pseudomyxoma peritonei (n = 3), mesothelium (n = 2), ovaries (n = 2), jejunum (n = 2), gallbladder (n = 1), urachus (n = 1), and peritoneal carcinomatosis (n = 2). After CS, IPHC with mitomycin (MMC) was administered by perfusion at 40.5 degrees C. After IPHC, multiple radiographs of the chest were reviewed in comparison to the control group.


RESULTS
Thoracic complications occurred in 36 patients (86%), including atelectasis in 32 patients (76%), pleural effusions in 27 (64%), pulmonary edema in 10 (24%), pneumonia in 2 (5%), and pneumothorax in 2 (5%). The incidence of thoracic complications in the IPHC group was significantly higher than that of patients in the control group (P < .05). Correlations between the prevalence of pleural effusion and the dose of MMC, duration of procedure, and presence of thrombocytopenia were not significant (P > .05).


CONCLUSIONS
Bibasilar atelectasis and pleural effusions are common findings after IPHC with MMC, but most of them do not necessarily warrant intervention.
Chen
M Y
MY
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1088, USA. mchen@bgsm.edu
Chiles
C
C
Loggie
B W
BW
Choplin
R H
RH
Perini
M A
MA
Fleming
R A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016066:Pleural Effusion, Malignant / Q000209:etiology*; D001261:Pulmonary Atelectasis / Q000209:etiology*; D011654:Pulmonary Edema / Q000209:etiology; D012189:Retrospective Studies
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin