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Implications of Hyperthermic Intraperitoneal Chemotherapy Perfusion-Related Hyperglycemia.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2018 Mar; Vol. 25 (3), pp. 655-659. Date of Electronic Publication: 2017 Dec 04. - Publication Year :
- 2018
-
Abstract
- Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) administration can be associated with hyperglycemia during perfusion. Little is known about this effect, and no previous studies have examined patient characteristics associated with perfusion-related hyperglycemia.<br />Methods: We retrospectively identified consecutive patients at a single institution treated with HIPEC from 8/2003 to 10/2016 who had intraoperative blood glucose measured. Hypertonic 1.5% dextrose-containing peritoneal dialysate was used as carrier solution in all patients. Comparisons were made using parametric [Student's t test, analysis of variance (ANOVA)], and nonparametric tests (χ <superscript>2</superscript> , Kruskal-Wallis) where appropriate.<br />Results: There were 85 patients identified, with average age of 53 ± 12 years, 69 (81%) with appendiceal or colorectal peritoneal cancer. Most patients were perfused with mitomycin C (69%) or oxaliplatin (24%). Intraoperative hyperglycemia (> 180 mg/dL) affected the majority of patients (86%), with values up to 651 mg/dL. Insulin was required for treatment in 66% of patients. Peak hyperglycemia occurred within an hour of perfusion in 91%, and resolved by postoperative day one in 91% of patients. Glucose > 309 mg/dL (highest quartile) was associated with longer operating time (p = 0.03) and with use of oxaliplatin compared with mitomycin C (p = 0.01). No association was found with other comorbidities, peritoneal carcinomatosis index score, or postoperative outcomes.<br />Conclusions: Most patients experience hyperglycemia during HIPEC. This is not clearly associated with patient factors, and may be due to use of dextrose-containing carrier solution. Since perioperative hyperglycemia has potential negative impact, use of dextrose-containing carrier solution should be questioned and is worth investigating further.
- Subjects :
- Adolescent
Adult
Aged
Appendiceal Neoplasms pathology
Colorectal Neoplasms pathology
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Peritoneal Neoplasms pathology
Prognosis
Retrospective Studies
Young Adult
Antineoplastic Combined Chemotherapy Protocols adverse effects
Appendiceal Neoplasms therapy
Colorectal Neoplasms therapy
Cytoreduction Surgical Procedures adverse effects
Hyperglycemia etiology
Hyperthermia, Induced adverse effects
Peritoneal Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 25
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 29204776
- Full Text :
- https://doi.org/10.1245/s10434-017-6284-6