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Review
. 2024 Oct 18;39(1):167.
doi: 10.1007/s00384-024-04741-5.

Risk factors for postoperative complications in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: A meta-analysis and systematic review

Dengzhuo Chen #  1   2   3 , Yongli Ma #  2 , Jinghui Li #  1   2   3 , Liang Wen #  1   2   3 , Guosheng Zhang  2 , Chengzhi Huang  4 , Xueqing Yao  5   6   7
Affiliations
Review

Risk factors for postoperative complications in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: A meta-analysis and systematic review

Dengzhuo Chen et al. Int J Colorectal Dis. .

Abstract

Objective: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is one of the most effective treatments for intraperitoneal malignancies. However, current research on risk factors for postoperative complications needs to be more consistent. This study aimed to conduct a meta-analysis of the risk factors for postoperative complications in CRS + HIPEC patients.

Methods: Studies meeting the inclusion criteria were screened by searching the Embase, PubMed, Cochrane and Web of Science databases. RevMan and STATA software were used to analyze the data extracted from the included articles.

Results: A total of 15 articles with 4021 patients were included in the meta-analysis. The results revealed that sex, elevated peritoneal cancer index, prolonged duration of surgery and smoking habits were risk factors for postoperative complications in CRS + HIPEC patients. In contrast, BMI, eGFR, age, history of preoperative chemotherapy, history of preoperative surgery, and history of neoadjuvant therapy had no significant effect on postoperative complications in the CRS + HIPEC group. The effects of diabetes, hypertension, preoperative albumin level, tumor location and chemotherapy regimen on the occurrence of complications need to be further investigated.

Conclusions: We identified several risk factors for postoperative complications after CRS + HIPEC, which should help clinicians minimize the incidence of postoperative complications and make more beneficial decisions for cancer patients who need treatment.

Keywords: CRS; HIPEC; Meta-analysis; Postoperative complication; Risk factor.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA fow diagram for study selection
Fig. 2
Fig. 2
Forest plot A sex B age(continuous variable) C age(< 60/ ≥ 60) D Body Mass Index(BMI) E smoking F Peritoneal cancer index(PCI)
Fig. 2
Fig. 2
Forest plot A sex B age(continuous variable) C age(< 60/ ≥ 60) D Body Mass Index(BMI) E smoking F Peritoneal cancer index(PCI)
Fig. 3
Fig. 3
Forest plot A surgery history B chemotherapy history C neoadjuvant therapy D operation time E mitomycin regimen F cisplatin regimen
Fig. 3
Fig. 3
Forest plot A surgery history B chemotherapy history C neoadjuvant therapy D operation time E mitomycin regimen F cisplatin regimen
Fig. 4
Fig. 4
Publication bias and sensitivity analysis for age studys A Funnel plot B Egger test figure C Egger test results D Sensitivity analysis plot
Fig. 4
Fig. 4
Publication bias and sensitivity analysis for age studys A Funnel plot B Egger test figure C Egger test results D Sensitivity analysis plot
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