Toxicity of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy
(2004) In Journal of Surgical Oncology 85(2). p.7-61- Abstract
BACKGROUND AND OBJECTIVES: Cytoreduction with hyperthermic intra-peritoneal chemotherapy (HIPEC) is a treatment with a high morbidity. Optimal patients selection can possible reduce toxicity and complications.
PATIENTS AND METHODS: Complications and toxicity of 102 patients were studied. Toxicity was graded according National Cancer Institute Common Toxicity Criteria (NCI CTC) classification. A complication was defined as any post-operative event that needed re-intervention. Potential patients, tumor, and treatment factors were studied on their relation to complications.
RESULTS: Grade 3, 4, or 5 toxicity was observed in 66 patients (65%). Eight patients died of treatment-related causes. Surgical complications occurred in 36... (More)
BACKGROUND AND OBJECTIVES: Cytoreduction with hyperthermic intra-peritoneal chemotherapy (HIPEC) is a treatment with a high morbidity. Optimal patients selection can possible reduce toxicity and complications.
PATIENTS AND METHODS: Complications and toxicity of 102 patients were studied. Toxicity was graded according National Cancer Institute Common Toxicity Criteria (NCI CTC) classification. A complication was defined as any post-operative event that needed re-intervention. Potential patients, tumor, and treatment factors were studied on their relation to complications.
RESULTS: Grade 3, 4, or 5 toxicity was observed in 66 patients (65%). Eight patients died of treatment-related causes. Surgical complications occurred in 36 patients (35%). Fistulae were frequently encountered (18 patients). The risk of a complicated recovery was higher in carcinomatosis with recurrent colorectal cancer (P = 0.009) and in the case of more than five regions affected (P = 0.044), who had a Simplified Peritoneal Cancer (SPC) score of 13 (P = 0.012) and with an incomplete initial cytoreduction (P = 0.035). Patients with blood loss exceeding 6 L (P = 0.028) and those with three or more anastomoses also had an increased post-operative complication rate (P = 0.018).
CONCLUSIONS: Toxicity of cytoreduction followed by HIPEC was 65% (Grade 3-5 NCI CTC), with a surgical complication rate of 35%. Patients with six or seven regions involved and those in whom complete cytoreduction cannot be reached are probably better off without this treatment.
(Less)
- author
- Verwaal, Vic J LU ; van Tinteren, Harm ; Ruth, Serge V and Zoetmulder, Frans A N
- publishing date
- 2004-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Appendiceal Neoplasms, Carcinoma/drug therapy, Cecum/surgery, Chemotherapy, Adjuvant, Colorectal Neoplasms/drug therapy, Female, Fluorouracil/administration & dosage, Humans, Hyperthermia, Induced, Hysterectomy, Infusions, Parenteral, Intestine, Small/surgery, Leucovorin/administration & dosage, Male, Middle Aged, Peritoneal Neoplasms/drug therapy, Postoperative Complications/epidemiology, Postoperative Nausea and Vomiting/etiology, Rectum/surgery, Survival Analysis
- in
- Journal of Surgical Oncology
- volume
- 85
- issue
- 2
- pages
- 7 - 61
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:14755505
- scopus:0742322748
- ISSN
- 0022-4790
- DOI
- 10.1002/jso.20013
- language
- English
- LU publication?
- no
- additional info
- Copyright 2004 Wiley-Liss, Inc.
- id
- baea1fc5-9d51-43df-b3de-32293c213c0a
- date added to LUP
- 2022-04-12 10:50:45
- date last changed
- 2024-05-30 11:26:07
@article{baea1fc5-9d51-43df-b3de-32293c213c0a,
abstract = {{<p>BACKGROUND AND OBJECTIVES: Cytoreduction with hyperthermic intra-peritoneal chemotherapy (HIPEC) is a treatment with a high morbidity. Optimal patients selection can possible reduce toxicity and complications.</p><p>PATIENTS AND METHODS: Complications and toxicity of 102 patients were studied. Toxicity was graded according National Cancer Institute Common Toxicity Criteria (NCI CTC) classification. A complication was defined as any post-operative event that needed re-intervention. Potential patients, tumor, and treatment factors were studied on their relation to complications.</p><p>RESULTS: Grade 3, 4, or 5 toxicity was observed in 66 patients (65%). Eight patients died of treatment-related causes. Surgical complications occurred in 36 patients (35%). Fistulae were frequently encountered (18 patients). The risk of a complicated recovery was higher in carcinomatosis with recurrent colorectal cancer (P = 0.009) and in the case of more than five regions affected (P = 0.044), who had a Simplified Peritoneal Cancer (SPC) score of 13 (P = 0.012) and with an incomplete initial cytoreduction (P = 0.035). Patients with blood loss exceeding 6 L (P = 0.028) and those with three or more anastomoses also had an increased post-operative complication rate (P = 0.018).</p><p>CONCLUSIONS: Toxicity of cytoreduction followed by HIPEC was 65% (Grade 3-5 NCI CTC), with a surgical complication rate of 35%. Patients with six or seven regions involved and those in whom complete cytoreduction cannot be reached are probably better off without this treatment.</p>}},
author = {{Verwaal, Vic J and van Tinteren, Harm and Ruth, Serge V and Zoetmulder, Frans A N}},
issn = {{0022-4790}},
keywords = {{Adult; Aged; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Appendiceal Neoplasms; Carcinoma/drug therapy; Cecum/surgery; Chemotherapy, Adjuvant; Colorectal Neoplasms/drug therapy; Female; Fluorouracil/administration & dosage; Humans; Hyperthermia, Induced; Hysterectomy; Infusions, Parenteral; Intestine, Small/surgery; Leucovorin/administration & dosage; Male; Middle Aged; Peritoneal Neoplasms/drug therapy; Postoperative Complications/epidemiology; Postoperative Nausea and Vomiting/etiology; Rectum/surgery; Survival Analysis}},
language = {{eng}},
number = {{2}},
pages = {{7--61}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Surgical Oncology}},
title = {{Toxicity of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy}},
url = {{http://dx.doi.org/10.1002/jso.20013}},
doi = {{10.1002/jso.20013}},
volume = {{85}},
year = {{2004}},
}