Comparative Analysis of Postoperative Complications after Cytoreductive Surgery and HIPEC in Gastric Cancer

Abstract

<b><i>Introduction:</i></b> Patients with advanced gastric cancer (AGC) frequently show peritoneal carcinomatosis (PC). PC reduces life expectancy and quality of life. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to improve overall survival. Nevertheless, it has been reported that CRS and HIPEC are accompanied by an increase in postoperative complications. The purpose of this study was to investigate the complications associated with CRS and HIPEC and overall and disease-free survival. <b><i>Methods:</i></b> Patients with AGC and PC, who received complete CRS and HIPEC, were included in the HIPEC group (<i>n</i> = 15). Patients with AGC but without PC, who received resection of the primary tumor alone, constituted the control group (<i>n</i> = 43). <b><i>Results:</i></b> Patients enrolled in the HIPEC group presented with a median PCI of 7. In comparison with the control group, no differences were found in patient characteristics, risk factors, pathological findings, and operative procedures. Twenty-five percentage of the patients in both groups suffered from serious postoperative complications (CDC ≥3a). Surgical and medical complications, rate of reoperation, and mortality did not differ. Also, the recurrence pattern, median survival, and 1- and 2-year survival rates showed no differences. <b><i>Conclusion:</i></b> CRS and HIPEC do not lead to an increased postoperative morbidity and mortality in AGC with PC. Albeit the poorer prognosis of patients with PC, survival of both groups was comparable.