597P - Hyperthermic intraperitoneal chemotherapy for the management of gastrointestinal cancers: An analysis of the immediate postoperative period

Background

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a procedure that involves cytoreductive surgery and delivering of high doses of chemotherapy into the abdominal cavity. It is mainly used to treat gastrointestinal cancers with peritoneal metastases. We analyzed our outcomes in terms of the immediate postoperative complications in the Intensity Care Unit (ICU) in patients submitted to the HIPEC procedure for advanced gastrointestinal tumors.

Methods

This is a cross-sectional retrospective study of patients diagnosed with gastrointestinal cancers submitted to the HIPEC procedure from January 2018 to June 2023, in a cancer institute. Clinical data was extracted from patient medical records and statistical analysis was performed using SPSS®, version 28.

Results

Eighty patients were included, with a median age of 53 years old. Thirty-seven (46%) were diagnosed with colon cancer, thirty-two (40%) with pseudomyxoma peritonei, seven (9%) with peritoneal mesothelioma, three (4%) with gastric cancer, and one (1%) with duodenal cancer. More than half of the patients were previously treated with induction chemotherapy, the majority using fluoropyrimidines. Regarding the chemotherapeutic agent used during the HIPEC procedure, 71 patients (89%) were treated with mitomycin, and the rest were treated with doxorubicin + cisplatin. The peritoneal cancer index (PCI) was between 0 and 39. All patients spent the immediate postoperative period in the Intensity Care Unit (ICU). The median stay in the ICU was 2 days [1-47 days]. Twenty-eight patients (35%) required vasopressors and/or invasive mechanical ventilation (IMV) postoperatively. Intraoperative blood loss correlates with the length of stay in the UCI, the total time of IMV, and the total time of vasopressor requirement. We also found a positive correlation between PCI and longer use of vasopressors, as well as between PCI and longer use of IMV.

Conclusions

This study is a report of “real world” use of the HIPEC procedure in advanced gastrointestinal cancers, regarding its immediate postoperative period. Despite its limitations, our data indicates that PCI and intraoperative blood loss might be predictors of complications in the ICU.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.