Feasibility of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced peritoneal surface tumors during the COVID-19 pandemic: A single-institution experience

J Surg Oncol. 2022 Dec;126(8):1375-1382. doi: 10.1002/jso.27083. Epub 2022 Sep 8.

Abstract

Background and objectives: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a complex treatment used in selected patients with peritoneal surface malignancies. HIPEC procedures are time and resource intensive. The primary aim of this analysis was to compare the experience of treating advanced abdominal tumors with CRS-HIPEC before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Patients included in this analysis received CRS-HIPEC at a single center during either a prepandemic (March 18, 2019-March 17, 2020) or pandemic (March 18, 2020-February 5, 2021) interval. A retrospective chart review was performed.

Results: Our analysis included 67 patients: 30 (45%) treated prepandemic and 37 (55%) treated during the pandemic. Median age at the time of operation was 58 years (interquartile range: [49-65]); 53% of patients were women. Patients treated during the pandemic presented with higher peritoneal cancer index (PCI) scores with 32% (n = 12) having a PCI > 20 at the time of surgery (p = 0.01). Five patients had delays in surgery due to the pandemic. Rates of overall postoperative morbidity, reoperation, and readmission were not different between the cohorts.

Conclusions: Despite presenting with more extensive disease, patients treated with CRS-HIPEC during the height of the COVID-19 pandemic had comparable perioperative outcomes to patients treated prepandemic.

Keywords: COVID-19; cytoreduction surgical procedures; hyperthermic intraperitoneal chemotherapy; peritoneal surface malignancies.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • COVID-19* / epidemiology
  • Chemotherapy, Cancer, Regional Perfusion / methods
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures / adverse effects
  • Feasibility Studies
  • Female
  • Humans
  • Hyperthermia, Induced* / adverse effects
  • Hyperthermic Intraperitoneal Chemotherapy
  • Male
  • Middle Aged
  • Pandemics
  • Peritoneal Neoplasms* / pathology
  • Retrospective Studies
  • Survival Rate