Short-Term Postoperative Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Pilot Study

Mediators Inflamm. 2017:2017:3605350. doi: 10.1155/2017/3605350. Epub 2017 Nov 9.

Abstract

Objectives: To assess the association between short-term postoperative cognitive dysfuction (POCD) and inflammtory response in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Design: A prospective cohort study.

Setting: University medical centre.

Participants: Fifty-one adult patients who had undergone CRS-HIPEC and twenty control participants.

Measurements: The inflammatory marker levels in plasma and cognitive function were measured.

Results: Twenty (39.2%, 20/51) patients developed POCD at 1 w after CRS-HIPEC. The patients with POCD had higher serum interleukin 1β (IL-1β), serum amyloid A (SAA), S100 calcium-binding protein β (S-100β), and high mobility group box-1 protein (HMGB-1) levels at 1 and 24 h postoperatively than patients without POCD. There was an association between POCD and the maximum IL-1β and S-100β concentrations in serum, which remained following adjustment for age and FBS.

Conclusion: In this pilot study, perioperative inflammatory marker levels increase significantly after CRS-HIPEC in adult patients, and such elevations are associated with the development of short-term cognitive dysfunction after this complex surgery. These results suggested the need for a larger RCT to replicate and confirm these findings.

MeSH terms

  • Adult
  • Cognitive Dysfunction / blood
  • Cognitive Dysfunction / surgery*
  • Cognitive Dysfunction / therapy*
  • Cytoreduction Surgical Procedures / adverse effects*
  • Female
  • HMGB1 Protein / blood
  • Humans
  • Hyperthermia, Induced / adverse effects*
  • Interleukin-1beta / blood
  • Male
  • Middle Aged
  • Postoperative Complications
  • Postoperative Period
  • Prospective Studies
  • S100 Calcium Binding Protein beta Subunit / blood
  • Serum Amyloid A Protein / metabolism

Substances

  • HMGB1 Protein
  • Interleukin-1beta
  • S100 Calcium Binding Protein beta Subunit
  • Serum Amyloid A Protein