Preoperative performance status predicts outcome following heated intraperitoneal chemotherapy.
BACKGROUND
Peritoneal carcinomatosis has a typical natural history of bowel obstruction and death. Significant evidence suggests that cytoreduction with heated intraperitoneal chemotherapy (HIPEC) improves long-term survival for these tumors.


METHODS
A retrospective case series of patients who underwent initial HIPEC treatment was performed at 2 moderate-volume centers. Clinicopathologic data were reviewed and univariate analyses performed to determine predictors of periprocedural complications.


RESULTS
Twenty-eight patients underwent HIPEC procedures. The most common pathologies were colonic adenocarcinoma and pseudomyxoma peritonei. The median preoperative peritoneal cancer index was 9.5. Thirteen patients had 34 complications, with no postoperative deaths. Pleural effusion and wound infection were the most common complications. Preoperative performance status and the extent of disease were predictive of complications.


CONCLUSIONS
Cytoreduction and HIPEC can be done at moderate-volume centers with morbidity and mortality rates comparable with published results from large-volume centers. Preoperative performance status and the extent of disease predict postoperative complications.
Reuter
Nathaniel P
NP
Department of Surgery, Division of Surgical Oncology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.
Macgregor
Jay M
JM
Woodall
Charles E
CE
Sticca
Robert P
RP
William
C
C
Helm
M B
MB
Scoggins
Charles R
CR
McMasters
Kelly M
KM
Martin
Robert C G
RC
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007267:Injections; D008875:Middle Aged; D010529:Peritoneal Cavity; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000970:Antineoplastic Agents