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.
Keywords: HIPEC; gastrointestinal tumors; hepatotoxicity; perioperative.