Intraoperative urinary tract resection and construction in CRS + HIPEC procedures: a single center retrospective analysis

World J Surg Oncol. 2024 Jun 26;22(1):171. doi: 10.1186/s12957-024-03457-8.

Abstract

Introduction: The safety and efficacy of CRS + HIPEC combined with urinary tract resection and reconstruction are controversial. This study aims to summarize the clinicopathological features and to evaluate the safety and survival prognosis of CRS + HIPEC combined with urinary tract resection and reconstruction.

Methods: The patients who underwent urinary tract resection and reconstruction as part of CRS surgery were retrospectively selected from our disease-specific database for analysis. The clinicopathological characteristics, treatment-related variables, perioperative adverse events (AEs), and survival outcomes were studied using a descriptive approach and the K-M analysis with log-rank comparison.

Results: Forty-nine patients were enrolled. Perioperative serious AEs (SAEs) were observed in 11 patients (22.4%), with urinary SAEs occurring in 3 patients (6.1%). Additionally, there were 23 cases (46.8%) involving urinary adverse events (UAEs). The median overall survival (OS) in the entire cohort was 59.2 (95%CI: 42.1-76.4) months. The median OS of the UAE group and No-UAE group were 59.2 months (95%CI not reached), and 50.5 (95%CI: 11.5 to 89.6) months, respectively, with no significant difference (P = 0.475). Furthermore, there were no significant differences in OS based on the grade of UAEs or the number of UAEs (P = 0.562 and P = 0.622, respectively).

Conclusion: The combination of CRS + HIPEC with urinary tract resection and reconstruction is associated with a high incidence of Grade I-II UAEs, which do not have an impact on OS. The safety profile of this combined technique is acceptable. However, this is a retrospective single-center single-arm analysis, with limitations of generalizability and potential selection bias. The findings need high-level validation.

Keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Urinary tract.

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures* / adverse effects
  • Cytoreduction Surgical Procedures* / methods
  • Cytoreduction Surgical Procedures* / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced* / adverse effects
  • Hyperthermia, Induced* / methods
  • Hyperthermia, Induced* / mortality
  • Hyperthermic Intraperitoneal Chemotherapy* / methods
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / therapy
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / etiology
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Urinary Tract / pathology
  • Urinary Tract / surgery
  • Urologic Surgical Procedures / methods