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International Journal of Surgical Oncology
Volume 2011, Article ID 468698, 10 pages
Clinical Study

Gastrointestinal Complications in 147 Consecutive Patients with Peritoneal Surface Malignancy Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

1Washington Cancer Institute, Washington Hospital Center, Washington, DC 20010, USA
2General Surgery and Gastroenterology Department, Reina Sofia University Hospital, Avenida Menéndez Pidal s/n., 14004 Córdoba, Spain
3Westat, Rockville, MD 20850-3129, USA

Received 3 June 2011; Accepted 13 August 2011

Academic Editor: Theodore D. Liakakos

Copyright © 2011 Angela Casado-Adam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly used in the treatment of peritoneal carcinomatosis from gastrointestinal malignancies. The purpose of this study is to reevaluate the incidence of gastrointestinal events and identify risk factors associated with this treatment approach. Between January 1, 2006 and December 31, 2009, 147 patients with appendiceal and colorectal carcinomatosis were treated. Gastrointestinal events were analyzed. The overall incidence of grade I–IV gastrointestinal events was 17%. There were 4 grade III gastrointestinal events that occurred in 4 patients and 11 grade IV gastrointestinal events that occurred in 8 patients. On univariate analysis of grade I–IV events a statistically significant association was observed with the following variables: histological grade, peritoneal cancer index (PCI), small bowel resection, colorectal anastomosis, and the number of anastomoses performed per patient. By multivariate analysis, PCI was identified as the only independent risk factor for gastrointestinal complications. CRS combined with a uniform HIPEC regimen is associated with a 17% gastrointestinal morbidity rate (grade I–IV). The frequency of gastrointestinal complications was associated with a large extent of disease measured by PCI (>30).