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Surg Oncol ; 34: 163-167, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32891323

RESUMEN

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 AND METHODS: 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.


Asunto(s)
Quimioterapia del Cáncer por Perfusión Regional/efectos adversos , Enfermedades Transmisibles/diagnóstico , Procedimientos Quirúrgicos de Citorreducción/efectos adversos , Hipertermia Inducida/efectos adversos , Quimioterapia Intraperitoneal Hipertérmica/efectos adversos , Mediadores de Inflamación/sangre , Neoplasias Ováricas/terapia , Complicaciones Posoperatorias/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Biomarcadores de Tumor/sangre , Terapia Combinada , Enfermedades Transmisibles/sangre , Enfermedades Transmisibles/etiología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Ováricas/patología , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/etiología , Pronóstico , Estudios Prospectivos , Receptores Inmunológicos/sangre , Estudios Retrospectivos
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