Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer

Both normothermic IPC and HIPEC significantly increase the risk of certain perioperative laboratory abnormalities - specifically, anemia, liver injury, and a hypercoagulable state - compared to surgery alone. Notably, the addition of hyperthermia does not appear to significantly exacerbate the overall toxicity when clinical stage is considered. The chemotherapeutic regimen and HIPEC technique (open vs closed) are key determinants of liver injury. These findings underscore the importance of tailoring IPC protocols and implementing targeted supportive measures, such as liver protection and thromboprophylaxis, to optimize treatment safety in GI cancer patients.