Epidemiology and risks for infection following cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy

  • O. C. SmibertEmail author
  • M. A. Slavin
  • B. Teh
  • A. G. Heriot
  • J. Penno
  • H. Ismail
  • K. A. Thursky
  • L. J. Worth
Original Article



CRS-HIPEC is associated with improved cancer survival but an increased risk of infection.


Consecutive patients undergoing CRS-HIPEC between January 2016 and May 2018 were retrospectively reviewed. Malignancy type, comorbidities, perioperative risk factors and infectious complications were captured, using standardised definitions. Association between risk factors and infection outcomes was evaluated by logistic regression modelling.


One-hundred patients underwent CRS-HIPEC, predominantly for colorectal cancer and pseudomyxoma peritonei. Overall, 43 (43.0%) experienced an infectious complication, including infections at surgical site (27), respiratory tract (9), urinary tract (11), Clostridium difficile (2) and post-operative sepsis (15). In most, infection onset was within 7 days post-operatively. Median length of hospitalisation was 19 days for patients with infection, compared to 8 days for those without (p = 0.000). There were no deaths at 60 days. Of variables potentially associated with surgical site infection, small bowel resection (OR 4.01, 95% confidence interval [CI] 1.53–10.83; p = 0.005) and number of resected viscera (OR 1.41, 95% CI 1.00–1.98; p = 0.048) were significantly associated with infection.


We demonstrate a significant burden of early infective complications in patients undergoing CRS-HIPEC. Higher-risk subgroups, including those with small bowel resection and increased number of resected viscera, may benefit from enhanced monitoring.


CRS-HIPEC Infection Surgical site infection 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.National Centre for Infections in CancerPeter MacCallum Cancer CentreMelbourneAustralia
  2. 2.Division of Cancer SurgeryPeter MacCallum Cancer CentreMelbourneAustralia
  3. 3.Division of PharmacyPeter MacCallum Cancer CentreMelbourneAustralia
  4. 4.Department of Cancer Anaesthesia, Perioperative and Pain MedicinePeter MacCallum Cancer CentreMelbourneAustralia

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