Readmissions After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: a US HIPEC Collaborative...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is associated with significant morbidity and readmissions.
• Previous research on CRS-HIPEC readmissions is limited by single-institution designs or insufficient database tumor details.

Purpose of the Study:

• To analyze preoperative and intraoperative patient and tumor details for associations with readmissions following CRS-HIPEC.
• To identify risk factors for 30-day and 31-90 day readmissions after CRS-HIPEC.

Main Methods:

• Utilized the 12-institution US HIPEC Collaborative Database from 1999-2017.
• Analyzed 2017 cases of CRS-HIPEC, examining preoperative and intraoperative patient and tumor characteristics.
• Performed statistical analysis to identify independent predictors of readmission.

Main Results:

• The 30-day readmission rate was 15.9%, with common causes including failure to thrive, infection, and ileus.
• Readmitted patients experienced higher rates of complications such as intra-abdominal abscess, ileus, and anastomotic leak.
• Independent predictors for 30-day readmission included ECOG score ≥ 3, depression, total parenteral nutrition, low anterior resection or partial colectomy, and stoma creation.

Conclusions:

• This study, the largest to date on CRS-HIPEC readmissions, found a 15.9% 30-day readmission rate.
• Preoperative functional status and depression, along with specific surgical procedures, predicted readmission, while tumor factors did not.
• Patients with identified risk factors or postoperative complications may require closer post-discharge monitoring.