Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS + HIPEC): An initial experience at a Tertiary care Hospital in Pakistan

Abstract

Objective: Cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is evolving technique for advance stage malignancies. Studies have shown that CRS and HIPEC improve survival, however initial published results were not promising in view of high morbidity 20% and mortality 4.8% rate, hence it has yet to be standard of care for certain malignancies and further trials are awaited. This study presents outcomes of HIPEC in a Single center of a developing country.

Methodology: Retrospective cross-sectional study conducted in Shifa International Hospital, Islamabad, Pakistan. Data is collected from January 2019 to December 2023. Patients who underwent CRS and HIPEC for curative intent were included in the study.  Quantitative analysis is represented by mean and standard deviation, qualitative analysis is represented by frequency and percentage.

Results: Total number of patients included were 50. Out of these 17 (34%) were Male, and 33(66%) Female. Ovarian carcinoma was most common pathology 36%, Adenocarcinoma Colon and Low grade Appendiceal Mucinous Neoplasm 24%. No 30-day mortality was observed in our study. Recurrence was observed in 16 (32%) patients. Patient with poor tumor biology had a higher rate of recurrence (p= 0.003). Mean Overall Survival among patient who underwent HIPEC was 45±3 months. For patients who had LAMN, mean survival was 50±5 months which was significantly better than rest of pathologies.

Conclusion: Cytoreduction and HIPEC offers a hope for patients with advance malignancy, however patient selection for undergoing HIPEC is of utmost importance.