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Short-term outcome of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy used as treatment of colo-rectal carcinomatosis: a multicentric study

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Abstract

The aim of this study is to assess the morbidity and mortality related to cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colo-rectal carcinomatosis. A retrospective multi-institutional study from seven Italian Centers was performed. One hundred and seventy-two patients, submitted to cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis of colorectal origin, were recorded. Postoperative morbidity was evaluated in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Post-operative mortality was evaluated as patients’ death within 60 days from surgical procedures. Predictors of morbidity were evaluated with univariate and multivariate analyses. Post-operative morbidity occurred in 83 patients (48.3%): grades 1–2 in 29 cases (16.9%), and grades 3–4 in 54 (31.4%). Mortality occurred in four cases (2.3%). Number of anastomoses (OR 1.45; 95% CI 1.05–2.00; p = 0.024), number of blood transfusions (OR 1.31; 95% CI 1.11–1.54; p = 0.001) and chemotherapy regimen [Oxaliplatin (OX): OR 2.87; 95% CI 1.22–6.75; p = 0.015] remained, in multivariate analysis, in a statistically significant correlation with overall morbidity. The only variable that was proven to have statistically significant correlation with 3–4 morbidity was the number of blood transfusions (OR 1.25; 95% CI 1.07–1.46; p = 0.005). Morbidity and mortality do not preclude the use of CRS plus HIPEC in the treatment of peritoneal carcinomatosis of colorectal origin.

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Authors and Affiliations

  1. Department of Human Pathology, Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, University of Messina, Via Consolare Valeria, 98125, Messina, Italy

    Antonio Macrì

  2. Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy

    Vincenzo Arcoraci & Claudia Giardina

  3. Department of Surgery, University of Genoa, Largo R. Benzi, 16132, Genoa, Italy

    Valerio Belgrano & Franco De Cian

  4. 1st Department of General Surgery, University of Verona, P.le A. Stefani, 37126, Verona, Italy

    Marina Caldana & Giovanni De Manzoni

  5. Department of Surgery “Pietro Valdoni”, Cytoreductive Surgery and Intraabdominal Chemotherapy Unit, University “Sapienza” of Rome, V.le del Policlinico, 00161, Rome, Italy

    Ludovica Carbonari & Paolo Sammartino

  6. Department of Medicine, Surgery and Neuroscience, University of Siena, Strada delle Scotte, 53100, Siena, Italy

    Tommaso Cioppa & Franco Roviello

  7. Department of Surgical Oncology, Candiolo Cancer Insitute, SP 142, 10060, Candiolo, Torino, Italy

    Michele De Simone, Manuela Robella & Marco Vaira

  8. Department of Surgery, San Raffaele Scientific Institute, Via Olgettina, 20132, Milan, Italy

    Francesca Muffatti & Elena Orsenigo

  9. Messina, Italy

    Edoardo Saladino

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  1. Antonio Macrì
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Correspondence to Antonio Macrì.

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Research involving human participants

The manuscript reports an observational retrospective study, so, on the basis of the resolution of the Authority for the Protection of Personal Data (Gazzetta Ufficiale N° 72 - March 26, 2012 – http://www.garanteprivacy.it/garante/doc.jsp?ID=1878276).

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Italian Peritoneal Surface Malignancies Oncoteam: Antonio Macrì, Franco De Cian, Giovanni De Manzoni, Michele De Simone, Elena Orsenigo, Manuela Robella, Franco Roviello, Paolo Sammartino, Marco Vaira.

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Macrì, A., Arcoraci, V., Belgrano, V. et al. Short-term outcome of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy used as treatment of colo-rectal carcinomatosis: a multicentric study. Updates Surg 72, 163–170 (2020). https://doi.org/10.1007/s13304-019-00691-8

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