Trends in the indications for and short-term outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Am J Surg. 2020 Mar;219(3):478-483. doi: 10.1016/j.amjsurg.2019.09.017. Epub 2019 Sep 19.


Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an increasingly utilized strategy for patients with peritoneal surface malignancies (PSM).

Methods: The US HIPEC Collaborative was retrospectively reviewed to compare the indications and perioperative outcomes of patients who underwent CRS ± HIPEC between 2000 and 2012 (P1) versus 2013-2017 (P2).

Results: Among 2,364 patients, 39% were from P1 and 61% from P2. The most common primary site was appendiceal (64%) while the median PCI was 13 and most patients had CCR 0 (60%) or 1 (25%). Over time, median estimated blood loss, need for transfusion, and length of hospital stay decreased. While the incidence of any (55% vs. 57%; p = 0.426) and Clavien III/IV complications did not change over time, there was a decrease in 90-day mortality (5% vs. 3%; p = 0.045).

Conclusion: CRS-HIPEC is increasingly performed for PSM at high-volume centers. Despite improvements in some perioperative outcomes and a reduction in postoperative mortality, morbidity rates remain high.

Keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Cytoreduction Surgical Procedures / trends*
  • Female
  • Humans
  • Hyperthermia, Induced / trends*
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care*
  • Peritoneal Neoplasms / therapy*
  • Retrospective Studies
  • United States