Evaluation of Perioperative Outcomes of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Treatment in Ovarian Cancer Patients Undergoing Interval Cytoreduction

Abstract

Background and Aim: To evaluate the intraoperative and postoperative outcomes of the patients underwent interval cytoreduction and hypertermic intraperitoneal chemotherapy Methods This retrospective study included 23 patients who underwent cytoreductive surgery with HIPEC for high-grade serous ovarian cancer between December 2021 and September 2023 at our gynecologic oncology unit. HIPEC was performed using cisplatin at a dose of 100 mg/m², with continuous perfusion at 42°C for 90 minutes. Clinical characteristics, including age, comorbidities, preoperative CA-125 levels, and surgical details, were collected. Intraoperative parameters such as the extent of resection, anesthesia duration, transfusions, and urine output were analyzed. Postoperative complications, including acute renal insufficiency (ARI), were evaluated using daily creatinine measurements. Statistical analyses were conducted using SPSS 25, with continuous variables presented as mean ± standard deviation or median (range). Results The mean age of patients was 61 ± 10 years, and 78.6% were postmenopausal. The median gravida and parity were 3 (range: 2–7). 69.6% had ascites, with a median volume of 1000 mL (0–3000 mL). The median peritoneal carcinomatosis index (PCI) score was 14 (6–28). Neoadjuvant chemotherapy was administered to 91.3% of patients, with a median interval of 31.6 ± 4.6 days between NACT and surgery. The most common procedures performed included omentectomy (100%), colonic resection (13%), small bowel resection (8.7%), and splenectomy (21.7%). The median operation time was 316 minutes, and the median intraoperative bleeding was 400 mL (300–1000 mL). Postoperatively, the median hospital stay was 10 days (5–19). Acute renal insufficiency (ARI) occurred in 21% of patients, while other complications included ileus (13%), wound infection (17%), and atelectasis (21%). Median creatinine levels were 0.8 mg/dL on Postoperative Day 1, 1.1 mg/dL on Postoperative Day 2, and 0.9 mg/dL on Postoperative Day 3, indicating a transient postoperative rise in renal dysfunction. Notably, all patients who required renal replacement therapy had received cisplatin-based HIPEC at a dose of 100 mg/m². The median urine output during HIPEC was 400 mL, suggesting the need for close renal monitoring. Conclusion Cytoreductive surgery with HIPEC in ovarian cancer is a feasible option for advanced ovarian cancer with acceptable renal and surgical morbidity

Keywords

• Interval cytoreduction
• Advanced ovarian cancer
• Hyperthermic intraperitoneal chemotherapy (HIPEC)

References

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