Hyperthermic Intraperitoneal Chemotherapy With Cisplatin and Doxorubicin for 90 Minutes Versus 60 Minutes After Cytoreductive Surgery (CRS). Does the 30-Minute Difference Matter? A Comparative Study in a High Volume Centre

Abstract

Background/aim: This study compared the perioperative outcomes after the same combination of hyperthermic intraperitoneal chemotherapy (HIPEC) compounds when administered for 90 min vs. 60 min, while all other therapy variables remained constant.

Patients and methods: A total of 120 patients were included with peritoneal surface malignancy who underwent cisplatin (75 mg/m²) and doxorubicin (15 mg/m²) closed HIPEC after cytoreductive surgery.

Results: Sixty-five patients (54.2%) in the 60 min and 55 patients (45.8%) in the 90 min HIPEC group were compared. Patients, tumor characteristics, and postoperative complications were comparable. The only significant difference was the rate of chest drain/pleural puncture with an incidence of 18.5% and 34.5% in the 60 min and 90 min group, respectively (p=0.045). After adjustment in a multi-variable regression analysis, the odds for patients with HIPEC 90 min of having chest drain or pleural puncture in comparison to patients with HIPEC 60 min was still higher, but not significant with an OR of 2.238 (95%CI=0.932-5.373; p=0.071).

Conclusion: HIPEC administered for 90 min is safe and does not increase perioperative morbidity and mortality compared to the 60-min administration.

Keywords: HIPEC duration; cisplatin; cytoreductive surgery; intraperitoneal chemotherapy.