ArticleJournal of surgical case reports2026
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy can be safely combined with nephrectomy in patients with appendiceal malignancy and synchronous renal cell carcinoma.
Article in Journal of surgical case reports, 2026. 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
The combination of an appendix tumour requiring cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) with the management of a renal cell cancer is rare but problematic. Acute kidney injury (AKI) is one of the major complications after CRS and HIPEC with concern that combining CRS and HIPEC with nephrectomy may further increase the risk of AKI. There is little published on this combined approach of CRS and HIPEC with nephrectomy for patients with disseminated appendiceal tumours. We report on eight patients who had CRS and HIPEC for an appendiceal tumour with synchronous nephrectomy. We performed a retrospective review of patients undergoing CRS and HIPEC for appendiceal malignancy and synchronous nephrectomy for renal cell carcinoma between 2014 and 2025. Patient demographics, operative details, pathology, postoperative morbidity and mortality were evaluated. A total of eight patients (M: F 4:4) with a median age of 65 were included, of which 5/8 (62.5%) presented with abdominal pain. Concerning the primary appendiceal pathology, CRS included right hemicolectomy or extended right hemicolectomy in 5/8 (67%). Regarding the renal pathology, 7/8 (87.5%) had either right or left nephrectomy and 1 (12.5%) had right partial nephrectomy. The mean operation time was 453.75 minutes (365-588). The mean blood loss was 1053 ml (420-2000). Mean Peritoneal Cancer Index was 13 (0-39). Complete cytoreduction was achieved in 5/8 (62.5%). Appendix tumour pathology was low grade appendiceal mucinous neoplasm in 5/8, goblet cell adenocarcinoma in 2/8 and high grade appendiceal mucinous neoplasm in 1. Pathology of the renal tumour was clear cell carcinoma in 4/8, papillary renal cell carcinoma in 3 and 1 patient with transitional cell carcinoma. Postoperative intensive care unit stay was a mean of 1 day (1-3). Median postoperative stay was 15 days (8-47). The mean drop in glomerular filtration rate was 10 ml/min/1.73 m
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