Hepatic resection and blood transfusion increase morbidity after cytoreductive surgery and HIPEC for colorectal carcinomatosis

Carla Soldevila Verdeguer; Juan José Segura Sampedro; Cristina Pineño Flores; Maria del Pilar Sanchís Cortés; Francesc Xavier González Argente; Rafael Morales Soriano

Ayuda

Hepatic resection and blood transfusion increase morbidity after cytoreductive surgery and HIPEC for colorectal carcinomatosis

C. Soldevila Verdeguer ^[1] ; J. J. Segura Sampedro ^[1] ; C. Pineño Flores ^[1] ; P. Sanchís Cortés ^[2] ; X. González Argente ^[1] ; R. Morales Soriano ^[1]
1. [1] Hospital Clinico Universitario de Valencia
  
  Hospital Clinico Universitario de Valencia
  
  Valencia, España
2. [2] Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 11, 2020, págs. 2032-2039
Idioma: inglés
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Resumen
- Background and objectivesCytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective but complex treatment for peritoneal metastasis (PM). Our objective was to identify risk factors for postoperative morbidity and mortality following CRS-HIPEC.MethodsRetrospective study of prospectively collected data of patients undergoing CRS-HIPEC for PM arises from colo-rectal cancer between January 2008 and December 2017. Perioperative variables were correlated with morbidity outcomes using a logistic regression model.ResultsSixty-seven patients underwent CRS-HIPEC, and overall morbidity and mortality were 31.3% and 4.5% respec-tively. Major morbidity rate was 19.4%; 7.5% of patients were re-operated. Intraoperative blood transfusion (p = 0.01), liver resection (p < 0.01), and intestinal anastomosis (p < 0.01) were associated with a higher morbidity in univariate analysis. A multivariate analysis identified blood transfusion and liver resection as independent risk factors (OR 3.66, IC 1.13–16.54; OR 4.33, IC 1.17–11.46, respectively). Extension of visceral resection did not correlate with morbidity. Patients with lymph-node infiltration had a higher major complication rate (p = 0.01).ConclusionsCRS-HIPEC is a feasible treatment for colorectal PM with an acceptable morbi-mortality rate in experienced centers. In our study, digestive anastomosis, perioperative blood transfusion, hepatic resection, and lymph-node infiltration were associated with higher morbidity rates.