Platinum agents and mitomycin C-specific complications in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

Figures & data

Figure 1. Flow diagram depicting distribution of study population by histology and chemotherapy administered.

Table 1. Demographics.

	Mitomycin C	Cisplatin	Oxaliplatin	p value	MMC vs. cisplatin	Cisplatin vs. oxaliplatin	MMC vs. oxaliplatin
Age (years)	52 ± 12	50 ± 12	55 ± 13	0.414	0.589	0.525	0.754
Gender				<0.001	<0.001	0.347	0.136
Female	62 (55%)	88 (96%)	7 (88%)
Male	51 (45%)	4 (4.3%)	1 (12%)
Preoperative albumin	38 ± 5.2	39 ± 5.8	36 ± 10	0.414	0.712	0.44	0.626
ECOG				0.76	0.592	0.61	1
0	101 (91%)	84 (93%)	8 (100%)
1	10 (9%)	6 (6.7%)	0 (0%)
Co-morbidities
Hypertension	31 (27%)	16 (17%)	2 (25%)	0.196	0.102	0.632	1
Diabetes	14 (12%)	6 (6.5%)	1 (12%)	0.372	0.25	0.453	1
Ischaemic heart disease	1 (0.88%)	1 (1.1%)	0 (0%)	0.95	1	1	1
COPD	1 (0.88%)	0 (0%)	0 (0%)	0.644	1	NA	1
Asthma	2 (1.8%)	3 (3.3%)	0 (0%)	0.703	0.658	1	1
Other malignancy	7 (6.2%)	11 (12%)	0 (0%)	0.223	0.222	0.654	1
Primary tumour				<0.001	<0.001	NA	<0.001
Colorectal	56 (50%)	1 (1.1%)	5 (62%)
Ovarian	1 (0.88%)	62 (67%)	2 (25%)
Appendix	46 (41%)	1 (1.1%)	1 (12%)
Mesothelioma	0 (0%)	10 (11%)	0 (0%)
Primary peritoneal	6 (5.3%)	9 (9.8%)	0 (0%)
Others	4 (3.5%)	9 (9.8%)	0 (0%)
Previous adjuvant therapy	67 (59%)	78 (85%)	7 (88%)	0.002	<0.001	1	0.151

Table 2. Details of CRS/HIPEC/EPIC regime.

	Mitomycin C	Cisplatin	Oxaliplatin	p value	MMC vs. cisplatin	Cisplatin vs. oxaliplatin	MMC vs. oxaliplatin
Duration of CRS/HIPEC (min)	530 ± 180	460 ± 150	530 ± 140	0.036	0.020	0.537	0.992
Incomplete cytoreduction	2 (1.9%)	1 (1.1%)	1 (12%)	0.085	1	0.162	0.193
Stoma	27 (30%)	18 (24%)	1 (33%)	0.036	0.435	0.567	1
HIPEC dosage (median, mg)	15 (14–20)	66 (50–75)	600 (580–610)
HIPEC temperature (median, °C)	42 (41–42)	40 (40–42)	not recorded
EPIC given	33 (30%)	34 (37%)	6 (75%)	0.075	0.293	0.058	0.042

Table 3. Grade of perioperative complications.

	Mitomycin C	Cisplatin	Oxaliplatin	p value	MMC vs. cisplatin	Cisplatin vs. oxaliplatin	MMC vs. oxaliplatin
Estimated blood loss (ml)	1600 ± 1700	1400 ± 1300	950 ± 460	0.29	0.438	0.755	0.469
SICU stay (days)	1 (0–2)	1 (0–2)	1 (0.75–3.2)	0.241	0.213	0.977	0.898
Total hospital stay (days)	14 (10–19)	14 (11–19)	18 (14–24)	0.22	0.387	0.321	0.724
Complications
Grade I	14 (12%)	20 (22%)	1 (12%)	0.181	0.103	1	1
Grade II	31 (27%)	25 (27%)	3 (38%)	0.814	1	0.683	0.684
Grade III	17 (15%)	16 (17%)	4 (50%)	0.496	0.905	0.097	0.104
Grade IV	7 (6.2%)	6 (6.5%)	0 (0%)	0.759	1	1	1
Grade V	0 (0%)	2 (2.2%)	0 (0%)	0.262	0.198	1	NA
Simple complications (grade I–II)	45 (40%)	45 (49%)	4 (50%)	0.374	0.224	1	0.713
Serious complications (grade III–V)	23 (20%)	22 (24%)	4 (50%)	0.172	0.748	0.2	0.080

Table 4. Details of perioperative complications.

	Mitomycin C	Cisplatin	Oxaliplatin	p value	MMC vs. cisplatin	Cisplatin vs. oxaliplatin	MMC vs. oxaliplatin
Respiratory	19 (17%)	13 (14%)	6 (75%)	0.001	0.759	0.001	0.002
Intraabdominal collection	10 (8.8%)	10 (11%)	1 (12%)	0.852	0.788	1	0.541
Enterocutaneous fistula	1 (0.88%)	3 (3.3%)	0 (0%)	0.42	0.326	1	1
Anastomotic leak	5 (4.4%)	1 (1.1%)	0 (0%)	0.321	0.228	1	1
Bleeding	1 (0.88%)	1 (1.1%)	2 (25%)	<0.001	1	0.049	0.043
Chemical peritonitis	0 (0%)	1 (1.1%)	0 (0%)	0.514	0.447	1	NA
Pneumonia	7 (6.2%)	4 (4.3%)	1 (12%)	0.59	0.758	0.347	0.428
Wound infection	8 (7.1%)	5 (5.4%)	1 (12%)	0.708	0.776	0.402	0.469
Ileus	7 (6.2%)	2 (2.2%)	0 (0%)	0.308	0.304	1	1
UTI	2 (1.8%)	2 (2.2%)	0 (0%)	0.807	0.772	1	1
Neutropenia				0.91	1	1	1
Mild	1 (1.2%)	1 (1.3%)	0 (0%)
Moderate	1 (1.2%)	0 (0%)	0 (0%)
Severe	0 (0%)	0 (0%)	0 (0%)
Acute renal impairment (any grade)	6 (5.6%)	32 (36%)	5 (62%)	<0.001	<0.001	0.15	<0.001
Acute renal impairment				<0.001	<0.001	0.0687	<0.001
None	102 (94%)	58 (64%)	3 (38%)
Grade 1	4 (3.7%)	11 (12%)	2 (25%)
Grade 2	1 (0.93%)	7 (7.8%)	3 (38%)
Grade 3	1 (0.93%)	9 (10%)	0 (0%)
Grade 4	0 (0%)	5 (5.6%)	0 (0%)