Morbidity and Mortality of Patients with Ovarian Cancer After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Hyperthermic Intraperitoneal Chemotherapy

Background: Epithelial ovarian cancer (EOC) remains the leading cause of death due to gynecological malignancy, largely because of the large percentage of advanced stage disease (FIGO stage >II) at initial diagnosis. Although the survival benefit of complete surgical cytoreduction is well established, more than half of patients experience recurrent disease. The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising treatment option targeting peritoneal carcinomatosis. Associated morbidity remains a significant issue hindering widespread technique’s implementation. Our aim is to evaluate the morbidity and mortality of HIPEC and CRS. Patients-Methods: Patients presenting to our department with EOC from 01/2005 to 12/2020 were included in the study. All patients were operated by the same surgical team with curative intent. Patients’ demographics, perioperative and follow-up data were collected and analyzed. Results: A total of 284 patients with EOC were subjected to cytoreductive surgery with HIPEC administration during the study period. Mean age was 57.2 and average PCI (peritoneal cancer index) 12.9. Length of hospital stay was 13.6 days and operation time averaged 360 minutes. Overall 30-day mortality rate was 2.1% (6/284). Significant complications were encountered in 65 patients (22.9%). ASA score, blood loss and PCI score significantly predicted postoperative complications. Age, administration of NACT and the need for extensive lymph node dissection did not correlate with perioperative outcomes. Conclusions: The addition of HIPEC to cytoreductive surgery show promising results regarding efficacy feasibility with acceptable peri-operative morbidity and mortality when performed in high volume centers by specialized personnel.