Abstract 46: Safety of Patients Undergoing Hyperthermic Intraoperative Chemotherapy Using a Cost-Effective, Modified Perfusion System

Abstract Purpose: Cytoreductive surgery (CRS) along with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is being increasingly used to treat peritoneal surface malignancy (PSM) in various cancers including colorectal, gastric, ovarian and appendiceal neoplasms. However, the procedure requires expensive equipment which is unaffordable to many patients. We present our experience in delivering HIPEC through an inexpensive, cost-effective modified perfusion system. Methods: Consecutive patients who underwent CRS and HIPEC at Aga Khan University Hospital were included. All patients underwent oncological resection and received HIPEC with Mitomycin-C for 90 minutes via our modified perfusion system. Temperature was recorded using one inflow probe, and two outflow probes, and maintained at 42C. Outcomes were assessed in terms of safety of operating room personnel and patient safety including post-operative morbidity and mortality. Association with risk factors was determined by using Chi-square test. Results: 30 patients were included in the study, including 53.3% females with mean age of 48.7 years. Most frequent primary site of tumor was appendix (53.3%) followed by colon and rectum (33.3%), stomach (10%) and ovaries (10%). Intraoperative procedures ranged from colectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy, total or distal gastrectomy and excision of retroperitoneal tumor. All patients underwent partial peritonectomy. Completeness of cytoreductive surgery (CCR) Score was recorded in 14 patients out of which 16% had CCR-0. Mean surgical PCI was 18. There was no reporting of inadequate count, intra-operative chemotherapy spillage, electrosurgery related adverse event or intra-operative cardiac event. 30-day morbidity and mortality was seen in 8 (26.7%) and 0 patients. Catheter and line associated infections were observed in 3 (10%) patients. As per Clavien-Dindo classification system, the frequency of level III and above complications in our patients was 4(13.3%). 2 patients required exploration for control of bleeding. 1 patient required re-exploration for iatrogenic jejunal perforation. There was no association between age, preoperative body mass index (BMI), and radiological PCI with 30- day morbidity. Conclusion: We are a low volume center. Our data analysis shows our method of delivering HIPEC via our modified perfusion system is safe and cost-effective with morbidity comparable to that described in literature. Citation Format: Asfia Arham Khursheed, Nargis Maqbool, Khawaja Muhammad Inam Pal. Safety of Patients Undergoing Hyperthermic Intraoperative Chemotherapy Using a Cost-Effective, Modified Perfusion System [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 46.