BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly used in peritoneal carcinomatosis (PC) management. This modality is criticized for its high morbidity and mortality. We evaluate the morbidity and mortality of patients undergoing this procedure in our institution. METHODS A review of our institution's database was performed. All patients who underwent CRS/HIPEC between July 2011 and March 2018 were divided into three groups: no, low-grade, and high-grade complications. Prognostic factors were determined with Cox regression, while morbidity risk factors were analyzed using multinomial logistic regression. RESULTS 225 consecutive patients underwent CRS/HIPEC. The most common primary cancer types were colorectal (35.1%), appendiceal (25.8%), and ovarian (22.2%). Median age was 55 years old (range 14-77), and patients were typically female (68.0%). 38.7% developed low-grade complications and 14.7% had high-grade complications. No 30-day mortality was observed. Different tumor origins are associated with significant differences in overall survival (p < 0.001). Patients without complications had significantly better survival than those with high-grade complications (HR 0.35, 95% CI 0.15-0.81, p < 0.001). Males were more likely to develop low-grade complications (OR 3.30, 95% CI 1.31-8.30, p = 0.011). Intra-operative blood loss was associated with greater odds of developing any post-operative complications (OR 1.001, 95% CI 1.0003-1.002, p = 0.007; and OR 1.002, 95% CI 1.001-1.002, p < 0.001, for low and high grade, respectively). CONCLUSION Presence of high-grade complication was associated with poorer survival in patients after CRS/HIPEC. Pre-operative careful assessment of patients is pivotal to ensure favorable patient outcome following this complex procedure.

中文翻译：

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高级别并发症与细胞减灭术和腹膜内高温化疗后的总体生存不良有关。

背景技术细胞减少手术（CRS）和腹膜内高温化疗（HIPEC）越来越多地用于腹膜癌（PC）管理中。人们批评这种方式的高发病率和高死亡率。我们在我们的机构中​​评估接受此程序的患者的发病率和死亡率。方法对我们机构的数据库进行了审查。在2011年7月至2018年3月期间接受CRS / HIPEC的所有患者分为三组：无，低度和高度并发症。通过Cox回归确定预后因素，并使用多项Logistic回归分析发病率危险因素。结果连续225例患者接受了CRS / HIPEC。最常见的原发癌类型为大肠癌（35.1％），阑尾癌（25.8％）和卵巢癌（22.2％）。中位年龄为55岁（范围14-77），患者通常为女性（68.0％）。38.7％发生低度并发症，14.7％发生高度并发症。没有观察到30天的死亡率。不同的肿瘤起源与总生存期的显着差异相关（p <0.001）。没有并发症的患者的生存率明显高于有高度并发症的患者（HR 0.35，95％CI 0.15-0.81，p <0.001）。男性更有可能发生低度并发症（OR 3.30，95％CI 1.31-8.30，p = 0.011）。术中失血与发生任何术后并发症的几率更大相关（OR 1.001，95％CI 1.0003-1.002，p = 0.007; OR 1.002，95％CI 1.001-1.002，p <0.001，低和低高等级）。结论CRS / HIPEC术后高级别并发症的存在与较差的生存率有关。术前对患者进行仔细评估，对于确保在执行此复杂程序后获得良好的患者结果至关重要。