The incidence and risk factors of hepatotoxicity induced by perioperative hyperthermic intraperitoneal chemotherapy in gastrointestinal carcinoma patients: a retrospective study

Abstract

Aim

To investigate the incidence and risk factors of hepatotoxicity induced by perioperative hyperthermic intraperitoneal chemotherapy (HIPEC) in gastrointestinal carcinoma patients.

Patients and methods

Patients with gastrointestinal cancers treated with surgery in the presence or absence of HIPEC at a single institution were retrospectively reviewed. The patients received the treatment of surgery + HIPEC or surgery alone. The incidence of hepatotoxicity induced by HIPEC was recorded and risk factors were analyzed.

Results

In total, 301 eligible patients were included in the study, with 201 cases in the surgery + HIPEC group and 100 cases in the surgery group alone. The incidence of hepatotoxicity in the surgery + HIPEC group was higher than that in the surgery-alone group (57.71% vs 42%, P<0.05). In univariate analysis, HIPEC regimens, HIPEC techniques, HIPEC duration, and gastrointestinal complications were associated with the incidence of hepatotoxicity ( P<0.05), while patient age, gender, tumor type, clinical stage, pathological type, blood transfusion, hepatitis B virus infection status, long-term alcohol use, and surgical techniques were not ( P>0.05). Multivariate analysis showed that HIPEC regimen was the main risk factor of hepatotoxicity induced by HIPEC, with cisplatin + docetaxel being an independent risk factor of the HIPEC-induced hepatotoxicity. Open HIPEC techniques and HIPEC duration more than 60 minutes tend to increase the incidence of hepatotoxicity.

Conclusion

Surgery + HIPEC increases the incidence of hepatotoxicity. HIPEC regimen is the main risk factor for hepatotoxicity induced by HIPEC. Further prospective study is needed to confirm our conclusion.