Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(3):300-306 | DOI: 10.5507/bp.2019.035

Evaluation and management of toxicity of cytoreductive surgery/hyperthermic intraperitoneal chemotherapy: the initial experience of a single centre study

Radmila Lemstrovaa, Dominika Flasarovaa, Martina Spisarovaa, Bohuslav Melichara,b, Martin Lovecekc, Roman Havlikc, Cestmir Neoralc, Beatrice Mohelnikova-Duchonovaa, Dusan Klosb
a Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
b Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
c Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic

Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment modality for peritoneal surface malignancies with efficacy reported in many trials. Discrepancies, however, in the indication criteria, the extent of the surgical procedure, HIPEC regimens and toxicity evaluation represent a problem when comparing this method with other therapeutic modalities.

Methods: We describe the initial experience with CRS/HIPEC using different chemotherapy regimens (oxaliplatin, cisplatin, mitomycin C and doxorubicin) at the Comprehensive Oncology Centre Olomouc.

Results: A perioperative mortality of 2% and perioperative morbidity of 11%, according to Clavien-Dindo were observed. Interestingly, all these patients underwent HIPEC with oxaliplatin 460 mg/m2. The median duration of admission to hospital was 6 days in the intensive care unit (range 2-28 days) and 7 days in the surgical ward (range 1-21 days). Hospital admission did not exceed 2 weeks in 75% of patients. These results are consistent with the published results of large centres performing this treatment modality mainly due to pre-operative preparation of patients and pre-treatment and post-treatment management of HIPEC/CRS toxicity. Evaluation of the efficacy in terms of time to progression and overall survival (OS) is limited by the short follow up period.

Conclusion: CRS/HIPEC performed is a safe method with low perioperative mortality.

Keywords: cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, oxaliplatin, mitomycin C, cisplatin, toxicity, adverse events, morbidity

Received: February 27, 2019; Revised: July 10, 2019; Accepted: July 22, 2019; Prepublished online: August 21, 2019; Published: September 17, 2020  Show citation

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Lemstrova, R., Flasarova, D., Spisarova, M., Melichar, B., Lovecek, M., Havlik, R., ... Klos, D. (2020). Evaluation and management of toxicity of cytoreductive surgery/hyperthermic intraperitoneal chemotherapy: the initial experience of a single centre study. Biomedical papers, 164(3), 300-306. doi: 10.5507/bp.2019.035
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