Yusuf Emre Aytin1, İbrahim Ethem Cakcak1, Tamer Sağıroğlu2

1Department of General Surgery, Trakya University Faculty of Medicine, Edirne, Türkiye
2Department of General Surgery, Namık Kemal University Faculty of Medicine, Tekirdağ, Türkiye


Objective: In this study, we aimed to determine the postoperative morbidity rate and identify demographic, clinical, and treatment-related variables that may be potential risk factors for morbidity in gastrointestinal tumor patients undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) with or without cytoreductive surgery (CRS).

Material and Methods: In this retrospective study, 60 patients who had undergone HIPEC due to gastrointestinal tumor between October 2017 and December 2019 were included. Systemic toxicities were graded and evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.

Results: Mean age of the patients was 60.43 ± 12.83. Primary tumor localization was the stomach in 33 patients (55%), colon in 21 (35%), rectum in five (8.3%), and appendix in one patient (1.7%). PCI mean value was 9.51 ± 10.92. CC-0 was applied in 37 (61.7%) patients, CC-1 in 11 (18.3%), CC-2 in 6 (10%), and CC-3 in six patients (10%). Morbidity was observed in 50 (83.33%) of the 60 patients participating in the study according to NCI-CTCAE v3.0 classification. Mild morbidity rate was 46.6%, severe morbidity rate was 36.6%, and mortality rate was 11.66%. Enteric diversion application, length of stay in the ICU, and length of hospital stay were shown to have a statistically significant effect on the NCI-CTCAE morbidity score (p= 0.046, p= 0.004, p< 0.001).

Conclusion: With proven beneficial effects on survival in patients with locally advanced gastrointestinal tumors, CRC and HIPEC are acceptable in these patients despite their increased morbidity and mortality rate. With new studies on this subject, morbidity and mortality rates may be reduced.

Keywords: Gastrointestinal tumor, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, morbidity, HIPEC

Cite this article as: Aytin YE, Cakcak İE, Sağıroğlu T. The evaluation of morbidity in gastrointestinal tumor patients underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). Turk J Surg 2023; 39 (1): 17-26.


Ethics Committee Approval

This study was approved by Trakya University Faculty of Medicine Deanery Scientific Research Ethics Committee (Decision no: 19/14, Date: 11.11.2019).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept – All of authors; Design – All of authors; Supervision – YEA, TS; Fundings - YEA, İEC; Materials - YEA, İEC; Data Collection and/ or Processing – YEA, İEC; Analysis and/or Interpretation – YEA, İEC; Literature Search – All of authors; Writing Manuscript – YEA, İEC; Critical Reviews – All of authors.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.


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