gms | German Medical Science

Background: The peritoneal carcinomatosis represents an advanced stage of various abdominal tumors. In selected patients, the combined therapy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may improve prognosis and relieve symptoms. At the same time it involves a relevant risk of complications. The aim of this study is to analyze the factors of gender and age as potential influence and risk factors after cytoreduction and HIPEC.

Materials and methods: The study was performed on 1711 patients with peritoneal carcinomatosis (917 female, 794 male). They were operated between 01/2001 and 07/2014 with combined technique of cytoreduction hyperhermic intraperitoneal chemotherapy (HIPEC) at six national HIPEC-centers. The clinical data were collected in a standardized database of the German Society for General and Visceral Surgery (DGAV). Statistical analysis was performed with SPSS 20 by IBM.

Results: Men compared to women showed significantly higher Odd's Ratio for postoperative complications: anastomotic leakage (p < 0.05), impaired wound healing (p < 0.01), reoperation (P < 0.05) and mortality (p < 0.001). Comparing the preoperative tumor burden based on the peritoneal cancer index (PCI), men compared to women had a significantly higher PCI (p < 0.001). In addition, a complete cytoreduction CC=0/1 was significantly more frequent in women (p < 0.01). A comparison of postoperative survival time showed that women survived significantly longer after CRS & HIPEC compared to men (p <0.05).

Conclusion: The results of the study speak for a higher risk of complications in men. Simultaneously, the tumor load is higher in men at time of surgery, this is accompanied by a more complicated surgical procedure. This explains why a complete cytoreduction couldn`t be performed more frequently in men. The postoperative survival is also affected by these complications.