M. L. Moreno1, E. Konrade1, T. Mouw2, M. Woody-Fowler1, C. Coker1, M. Jones1, M. Al-Kasspooles2 1University of Kansas,School Of Medicine,Kansas City, KS, USA 2University of Kansas Medical Center,Department Of Surgery,Kansas City, KS, USA
Introduction: While literature exists regarding the operative and clinical outcomes of CRS-HIPEC according to pathology, sample sizes remain low in most studies. The pathologic-specific outcomes have yet to be established in a large sample size.
Methods: A total of 230 patients who underwent cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) at the University of Kansas Medical Center (KUMC) were analyzed and sub-divided into five groups according to their primary tumor pathology. Morbidity, mortality, clinical outcomes, and perioperative outcomes were reviewed among the pathology specific subgroups. ANOVA and chi-squared statistical analysis were performed between groups to assess for statistical significance.
Results: The most common primary diagnosis was colonic adenocarcinoma (59.6%) followed by gynecologic primary (15.2%), other/unspecified (12.6%), appendiceal low-grade mucinous neoplasm (7.4%) and primary peritoneal (3.5%). The average length of hospital stay was 12.7 days in the primary gynecologic group, 11.4 days for other/unspecified, 10.4 days for colonic adenocarcinoma, 9.1 days for primary peritoneal and 8.1 for appendiceal low-grade mucinous neoplasm. Readmission rate was highest in other/unspecified (37.9%) and lowest in the low-grade appendiceal neoplasm group (17.6%) (p-value=0.68). Average comprehensive complication index (CCI) scores were highest in the primary gynecologic group (34) and lowest in the primary peritoneal (20.6) (p-value=0.19). However, the average CCI score for gynecologic malignancy was higher when compared to colonic adenocarcinoma, (p-value=0.01).
Conclusion: HIPEC is associated with longer length of stay and CCI scores in patients with a primary gynecologic diagnosis. No association was observed for readmission rates between subgroups.