TY - JOUR
T1 - Comparison of open and closed hyperthermic intraperitoneal chemotherapy
T2 - Results from the United States hyperthermic intraperitoneal chemotherapy collaborative
AU - Leiting, Jennifer L.
AU - Cloyd, Jordan M.
AU - Ahmed, Ahmed
AU - Fournier, Keith
AU - Lee, Andrew J.
AU - Dessureault, Sophie
AU - Felder, Seth
AU - Veerapong, Jula
AU - Baumgartner, Joel M.
AU - Clarke, Callisia
AU - Mogal, Harveshp
AU - Staley, Charles A.
AU - Zaidi, Mohammad Y.
AU - Patel, Sameer H.
AU - Ahmad, Syed A.
AU - Hendrix, Ryan J.
AU - Lambert, Laura
AU - Abbott, Daniel E.
AU - Pokrzywa, Courtney
AU - Raoof, Mustafa
AU - LaRocca, Christopher J.
AU - Johnston, Fabian M.
AU - Greer, Jonathan
AU - Grotz, Travis E.
N1 - Funding Information:
Supported by the National Center for Advancing Translational Sciences, No. UL1TR002377.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/7/15
Y1 - 2020/7/15
N2 - BACKGROUND Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis can be performed in two ways: Open or closed abdominal technique. AIM To evaluate the impact of HIPEC method on post-operative and long-term survival outcomes. METHODS Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative database. Post-operative, recurrence, and overall survival outcomes were compared between those who received open vs closed HIPEC. RESULTS Of the 1812 patients undergoing curative-intent CRS and HIPEC, 372 (21%) patients underwent open HIPEC and 1440 (79%) underwent closed HIPEC. There was no difference in re-operation or severe complications between the two groups. Closed HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d mortalities. On multi-variable analysis, closed HIPEC technique was not a significant predictor for overall survival (hazards ratio: 0.75, 95% confidence interval: 0.51-1.10, P = 0.14) or recurrence-free survival (hazards ratio: 1.39, 95% confidence interval: 1.00-1.93, P = 0.05) in the entire cohort. These findings remained consistent in the appendiceal and the colorectal subgroups. CONCLUSION In this multi-institutional analysis, the HIPEC method was not independently associated with relevant post-operative or long-term outcomes. HIPEC technique may be left to the discretion of the operating surgeon.
AB - BACKGROUND Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis can be performed in two ways: Open or closed abdominal technique. AIM To evaluate the impact of HIPEC method on post-operative and long-term survival outcomes. METHODS Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative database. Post-operative, recurrence, and overall survival outcomes were compared between those who received open vs closed HIPEC. RESULTS Of the 1812 patients undergoing curative-intent CRS and HIPEC, 372 (21%) patients underwent open HIPEC and 1440 (79%) underwent closed HIPEC. There was no difference in re-operation or severe complications between the two groups. Closed HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d mortalities. On multi-variable analysis, closed HIPEC technique was not a significant predictor for overall survival (hazards ratio: 0.75, 95% confidence interval: 0.51-1.10, P = 0.14) or recurrence-free survival (hazards ratio: 1.39, 95% confidence interval: 1.00-1.93, P = 0.05) in the entire cohort. These findings remained consistent in the appendiceal and the colorectal subgroups. CONCLUSION In this multi-institutional analysis, the HIPEC method was not independently associated with relevant post-operative or long-term outcomes. HIPEC technique may be left to the discretion of the operating surgeon.
KW - Cytoreductive surgery
KW - Mucinous appendiceal carcinoma
KW - Multi-institutional
UR - http://www.scopus.com/inward/record.url?scp=85089804301&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089804301&partnerID=8YFLogxK
U2 - 10.4251/wjgo.v12.i7.756
DO - 10.4251/wjgo.v12.i7.756
M3 - Article
C2 - 32864043
AN - SCOPUS:85089804301
SN - 1948-5204
VL - 12
SP - 756
EP - 767
JO - World Journal of Gastrointestinal Oncology
JF - World Journal of Gastrointestinal Oncology
IS - 7
ER -