Effect of a Concomitant Urologic Procedure on Outcomes Following Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

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Abstract

Background and Objectives:

To evaluate whether urologic procedures during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are associated with adverse postoperative outcomes.

Methods:

We identified patients who underwent CRS-HIPEC at our institution from 2001 to 2012 and compared outcomes between operations that did and did not include a urologic procedure.

Results:

A total of 938 CRS-HIPEC procedures were performed, 71 of which included a urologic intervention. Urologic interventions were associated with longer operative times (547 vs. 459 min, P < 0.001) and greater length of stay (15 vs. 12 days, P = 0.003). Major complications (Clavien III and IV) were more common in the urologic group (31% vs. 20%, P = 0.028). On multivariable analysis, urologic procedures were associated with a low anterior resection (OR: 2.25, 95%CI 1.07–4.74, P = 0.033) and a greater number of enteric anastomoses (OR: 1.83, 95%CI 1.31–2.56, P < 0.001). At a median follow up of 17 months (IQR 5.6–35 months), addition of a urologic procedure did not significantly impact overall survival for appendiceal or colorectal cancers.

Conclusion:

Urologic surgery at the time of CRS-HIPEC is associated with longer operative times, length of stay and increased risk of major complications, but not with decreased overall survival. J. Surg. Oncol. 2016;113:218–222. © 2016 Wiley Periodicals, Inc.

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