ArticleOpen medicine (Warsaw, Poland)2025
Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer.
Article in Open medicine (Warsaw, Poland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intraperitoneal (IP) chemotherapy (IPC), including hyperthermic intraperitoneal chemotherapy (HIPEC), has emerged as a promising approach to control peritoneal metastases in gastrointestinal (GI) cancers. However, the safety profile and toxicity spectrum of IPC remain incompletely understood. This study aimed to evaluate the incidence of hematologic and biochemical adverse reactions following surgery with or without IPC and to compare the toxicity profiles of normothermic IPC and HIPEC. Additionally, potential risk factors for liver injury were investigated to guide clinical management. Methods: In this retrospective cohort study, 449 patients with gastric or colorectal cancer undergoing surgical resection between January 2015 and September 2019 were analyzed. Patients were categorized into three groups: surgery alone ( Results: Baseline characteristics were comparable across groups except for clinical stage, with the HIPEC group having a higher percentage of advanced-stage patients (79.6 vs 59.8%, Conclusions: Both normothermic IPC and HIPEC significantly increase the risk of certain perioperative laboratory abnormalities - specifically, anemia, liver injury, and a hypercoagulable state - compared to surgery alone. Notably, the addition of hyperthermia does not appear to significantly exacerbate the overall toxicity when clinical stage is considered. The chemotherapeutic regimen and HIPEC technique (open vs closed) are key determinants of liver injury. These findings underscore the importance of tailoring IPC protocols and implementing targeted supportive measures, such as liver protection and thromboprophylaxis, to optimize treatment safety in GI cancer patients.
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