420P - Predictive factors of post-operative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis: A retrospective cohort study

Background

Cytoreductive surgery (CRS) is a major surgery which consist of extensive tumor debulking, peritonectomy, and multiple visceral resections. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a technique in which chemotherapy is delivered in a heated solution perfused throughout the peritoneal space. In centers performing CRS-HIPEC, a significant survival benefit were observed; However, the rate of post-operative complications remains high. Acute kidney injury is a post-operative complication associated with increased morbidity and mortality and may cause delay in adjuvant chemotherapy or worse, may render the patient ineligible to receive systemic chemotherapy.

Methods

This was a retrospective cohort study, data were collected among adult patients with peritoneal carcinomatosis from colorectal, appendiceal, gastric, gynecologic cancers, and primary peritoneal mesothelioma who underwent CRS-HIPEC between Jan. 2012 and Dec. 2021 at St. Luke’s Medical Center. Data were obtained retrospectively through review of electronic medical records.

Results

A total of 162 patients who met the inclusion criteria were included in the study. Most of the patients were above 60 years old (62; 38%), females (134; 83%), had normal BMI (90; 56%), with ECOG PS 1 (160; 99%) and without comorbidities (84; 52%). Most had gynecologic malignancy (101; 63%) with high tumor grade (92; 58%) and were given with intraperitoneal cisplatin (16l 68%). Elderly patients (OR 2.70 [95% CI 0.88-8.29]; p .043 < .05); with comorbidities (OR 6.52 [95% CI 3.2-13.2]; p .001 < .05); and was given intraperitoneal Cisplatin (OR 3.99 [95% CI 1.99-8.03]; p .001 < 05) were all found to be at a higher risk for developing AKI after CRS-HIPEC.

Conclusions

The investigation noted that the elderly patients with comorbidities were found to have the highest risk of developing post-operative AKI. The most common malignancy was gynecologic cancers with high tumor grade. Cisplatin was the most common intraperitoneal chemotherapy administered and was associated with higher risk of developing acute kidney injury compared to other chemotherapy agents.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.