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Complications and Toxicity After Abdominal and Pelvic Hypoxic Stop-Flow Perfusion Chemotherapy: Incidence and Assessment of Risk Factors

  • Pancreatic Tumors
  • Published:
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Abstract

Background

Controversial results regarding the efficacy and toxicity of hypoxic abdominal and pelvic stop-flow perfusion chemotherapy (SFP) have been reported in relatively small series. Hence, because adequate assessment of its benefit in large homogenous cohorts is missing, acceptable morbidity should initially be assured in a series of adequate size. Additionally, risk factors should be assessed for eventual patient selection.

Methods

The morbidity of abdominal and pelvic SFP performed on a miscellaneous group of patients in our institute was analyzed and potential risk factors for adverse events were evaluated.

Results

Seventy abdominal (n = 42) and pelvic (n = 28) SFP were performed on 55 patients. In total, 28 adverse effects were observed after 30 % of the procedures. Severe (grade 3) adverse events were recorded only after 4 % of the procedures, while treatment-related life-threatening events and deaths were not present. Abdominal procedures when compared with pelvic ones were associated with increased systemic toxicity (36 vs. 7 %, p = 0.005). Advanced age, gender, prior chemotherapy and/or radiotherapy, limited experience, repeated procedure, drug choice and omission of hemofiltration after SFP completion were not associated with statistically significant increase of procedures with overall or systemic adverse events.

Conclusions

In the present series, abdominal and pelvic SFP was associated with an acceptable morbidity, which was mostly mild or moderate. Abdominal procedures were associated with increased toxicity. This procedure seems to be repeatable and also well tolerated both by elderly patients and by patients who had undergone prior chemotherapy and/or radiotherapy, while hemofiltration does not appear to decrease the incidence of systemic toxicity.

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Acknowledgment

The authors thank Eugenia Bolbasis for her English-language review.

Conflict of Interest

All authors disclose no financial or personal conflict of interest.

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Authors and Affiliations

  1. Department of Surgical Oncology, Medical School of Crete University Hospital, Herakleion, Greece

    Eelco de Bree MD, John Romanos MD, John Tsogkas MD, John Askoxylakis MD, John Michalakis MD, Evangelos Volakakis MD, John Melissas MD, PhD & Dimitris D. Tsiftsis MD, PhD

  2. Department of Anaesthesiology, Medical School of Crete University Hospital, Herakleion, Greece

    Maria Metaxari MD

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  1. Eelco de Bree MD
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  2. John Romanos MD
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Correspondence to Eelco de Bree MD.

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de Bree, E., Romanos, J., Tsogkas, J. et al. Complications and Toxicity After Abdominal and Pelvic Hypoxic Stop-Flow Perfusion Chemotherapy: Incidence and Assessment of Risk Factors. Ann Surg Oncol 19, 3591–3597 (2012). https://doi.org/10.1245/s10434-012-2383-6

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  • DOI: https://doi.org/10.1245/s10434-012-2383-6

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