Hyperthermic Intrathoracic Chemotherapy Following Cytoreductive Surgery: A Single Centre Retrospective Analysis

Background and Aims: Cytoreductive surgery (CRS) combined with hyperthermic intrathoracic chemotherapy (HITHOC) enhances local cytotoxicity by delivering heated chemotherapeutic agents after macroscopic tumour debulking. The procedure requires one-lung ventilation, strict temperature regulation and vigilant hemodynamic and metabolic management, particularly in patients with comorbidities or undergoing major lung resections. The primary objective was to assess intraoperative changes in central venous pressure. The secondary objectives were to evaluate variations in nasopharyngeal temperature, serum lactate and serum creatinine during CRS and HITHOC. Methods: A retrospective review of 10 patients who underwent CRS with cisplatin-based HITHOC between January 2023 and August 2024 at a tertiary centre in North India was conducted. Demographics, preoperative diagnosis, intraoperative hemodynamic data, CVP and temperature trends and postoperative organ function were analysed. Results: All patients had thymoma. CVP and serum lactate increased significantly during HITHOC compared to baseline ( P = 0.002; P = 0.018, respectively). No significant changes were observed in serum creatinine or nasopharyngeal temperature. Conclusion: CRS with HITHOC is feasible and safe with meticulous perioperative planning, continuous cardiovascular monitoring and strict thermal management. Institutional protocols for chemotherapeutic handling and disposal remain essential to ensure healthcare worker safety.