Abstract:
Objective To analyze complications of malignant peritoneal mesothelioma (MPM) treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and identify the associated risk factors to prevent serious adverse events (SAEs).
Method Clinicopathological information from 154 patients with MPM, who underwent treatment with CRS+HIPEC, enrolled in Beijing Shijitan Hospital, Capital Medical University from April 2015 to November 2022 was retrospectively analyzed. The incidence of postoperative complications was statistically analyzed, and risk factors affecting SAEs were evaluated.
Results Among 154 MPM patients, adverse events occurred as follows: grade 1, n=10 (8.8%); grade 2, n=41 (36.3%); grade 3, n=53 (46.9%); grade 4, n=7 (6.2%); and grade 5, n=2 (1.8%). No adverse events were reported in 41 patients. The rate of SAEs requiring rescue was 5.8% (9/154), and the perioperative mortality rate was 1.3% (2/154). Univariate analysis revealed that peritoneal cancer index (PCI) (P=0.036), completeness of cytoreduction (CC) (P=0.004), number of peritoneal exfoliated areas (P=0.035), and preoperative CA125 level (P=0.025) were prognostic factors. Multivariate analysis revealed that the number of peritoneal exuded areas (odds ratio OR=0.360, P=0.024) and CC score (OR=0.325, P=0.003) were independent risk factors.
Conclusions To improve the therapeutic effect of achieving complete CRS, a reasonable grasp of the extent of CRS may be an important factor in reducing complications, especially the incidence of SAEs, and improving surgical safety.