269 A prospective study of factors predicting morbidity and mortality in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for advanced epithelial ovarian malignancy. (18th September 2019)

• Record Type: Journal Article
• Authors: Ahuja, VK; Somashekar, S; Ashwin, K; Zaveri, S; Rohit Kumar, C; Rauthan, A; Ramya, Y
• Is Part Of: International journal of gynecological cancer. Volume 29(2019)Supplement 3
• Page Start: A114
• Page End: A114
• Publication Date: 2019-09-18
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2019-IGCS.269
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: The risk of morbidity and mortality associated with CRS & HIPEC is substantial enough to make any surgeon think twice before adopting it. Knowing the factors that will predict morbidity would help us optimize outcomes & improve care. This study is an attempt to find such factors that predict morbidity. Methods: Patients diagnosed of peritoneal carcinomatosis from epithelial ovarian malignancy underwent CRS+ HIPEC from March 2012 to December 2017. All data prospectively entered in the HIPEC registry was analysed with main focus on morbidity and factors predicting morbidity . Results: Out of 110 patients, 20, 55, 35 underwent upfront, interval & secondary CRS+HIPEC respectively. Mean duration of surgery was 9.5 hours, blood loss 1250 mL & PCI 17. Total, upper & pelvic peritonectomy with glissons capsulectomy & mesenteric stripping was done in 42.5%, 68.1%, 69.3%, 14.7% & 4.3%respectively. Multivisceral, diaphragmatic & bowel resections were done in 20.9%, 40.5% & 57.5% respectively. G3-G5 morbidity was noted in 40%, major being surgical 30%, hematological 20%, electrolyte imbalances 19%. Performance status, mean PCI >14, duration of surgery >10 hours, multivisceral resections, upper quadrant peritonectomy & more than one anastomosis were found to be significant factors predicting morbidity on univariate analysis. On multivariate analysis performance status & upper quadrantectomy were significant factors. Conclusions: CRS + HIPEC for advanced epithelial ovarian malignancy can be done with acceptable morbidity & mortality. A dedicated team is a absolute necessity. We should be more cautious & give extra attention to patients with above mentioned risk factors to improve the quality of care & optimize outcomes with CRS+ HIPEC.