Systemic inflammatory markers for the detection of infectious complications and safe discharge after cytoreductive surgery and HIPEC.
Surg Oncol
; 34: 163-167, 2020 Sep.
Article
em En
| MEDLINE
| ID: mdl-32891323
ABSTRACT
INTRODUCTION:
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) in patients with ovarian peritoneal carcinomatosis may be associated with a high postoperative morbidity. An early discrimination of postoperative complications is crucial for both improving clinical outcomes and proposing a safe discharge. MATERIAL ANDMETHODS:
In a cohort of 122 patients with advanced ovarian cancer (FIGO III-IV), we analyzed the diagnostic performance of three systemic inflammatory markers (C-reactive protein, white blood cell count and systemic immune-inflammation index) between the 5th to 8th postoperative days to prediction postoperative infectious complications. An optimal cut-off value was established in order to discriminate between the group of patients who developed infectious complications or not during the postoperative period.RESULTS:
The median peritoneal carcinomatosis index (PCI) was 15. The overall infectious morbidity was 25.4% (31 patients out of 122), of which, 32% (10 patients out of 31) had suffered severe postoperative complications (Dindo-Clavien III-IV). The most accurate results for detecting infectious complications were obtained by using C-reactive protein, which presented an excellent diagnostic performance, especially on the 7th and 8th postoperative days (AUC = 0,857 and 0,920; respectively).CONCLUSIONS:
These results support that it is safe to discharge patients with C-reactive protein concentrations lower than 88 mg/L and 130 mg/L, on the 7th and 8th postoperative days, respectively.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ovarianas
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Complicações Pós-Operatórias
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Quimioterapia do Câncer por Perfusão Regional
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Doenças Transmissíveis
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Mediadores da Inflamação
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Procedimentos Cirúrgicos de Citorredução
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Quimioterapia Intraperitoneal Hipertérmica
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Hipertermia Induzida
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Surg Oncol
Ano de publicação:
2020
Tipo de documento:
Article