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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2019

01-01-2019 | Gastrointestinal Oncology

Morbidity and Mortality Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Data from the DGAV StuDoQ Registry with 2149 Consecutive Patients

Authors: Pompiliu Piso, MD, PhD, Sebastian D. Nedelcut, MD, Beate Rau, PhD, Alfred Königsrainer, PhD, Gabriel Glockzin, PD Dr, Michael A. Ströhlein, PhD, Rüdiger Hörbelt, PD Dr, Jörg Pelz, PhD

Published in: Annals of Surgical Oncology | Issue 1/2019

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Abstract

Background

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are performed for well-selected patients with peritoneal surface malignancies. This combined treatment is potentially associated with an increased rate of complications.

Objective

The aim of this paper was to analyze the morbidity and mortality of CRS and HIPEC in the German national registry.

Methods

We present a retrospective analysis of 2149 consecutive patients from 52 hospitals. The data were prospectively documented in the DGAV StuDoQ Registry between February 2011 and December 2016.

Results

Almost two-thirds of all patients had a colorectal malignancy; therefore, the most frequently performed resections were colectomies (54%) and rectal resections (30%). Only 36.2% of all patients had no anastomosis, and fewer than 20% of all patients were older than 70 years of age (16.4%). Enteric fistula and anastomotic leaks occurred in 10.5% of all cases. The reoperation rate was 14.6% (95% confidence interval [CI] 11.51–18.1). Major grade 3 and 4 complications (Clavien–Dindo classification) occurred in 19.3% of all patients, half of which were due to surgical complications. The overall 30-day postoperative hospital mortality was 2.3% (95% CI 1.02–3.85). Multivariate analysis showed an increased risk for morbidity associated with pancreatic resections (odds ratio [OR] 2.4), rectal resection (OR 1.5), or at least one anastomosis (OR 1.35), and mortality with reoperation (OR 8.7) or age > 70 years (OR 3.35).

Conclusions

CRS and HIPEC are associated with acceptable morbidity and low mortality. These results show that CRS and HIPEC can be safely performed nationwide when close mentoring by experienced centers is provided.
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Metadata
Title
Morbidity and Mortality Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Data from the DGAV StuDoQ Registry with 2149 Consecutive Patients
Authors
Pompiliu Piso, MD, PhD
Sebastian D. Nedelcut, MD
Beate Rau, PhD
Alfred Königsrainer, PhD
Gabriel Glockzin, PD Dr
Michael A. Ströhlein, PhD
Rüdiger Hörbelt, PD Dr
Jörg Pelz, PhD
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6992-6

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