L'utilisation de l'oxaliplatine au cours des chimiohyperthermies intrapéritonéales majore le risque de complications hémorragiques (Analyse des facteurs pronostiques)

Cytoreductive surgery (CRS) combined with hyperthermie intraperitoneal chemotherapy (HIPEC) is considered as a standard of care for the treatment of peritoneal carcinomatosis (PC). Use of oxaliplatin in HIPEC seems to increase the incidence postoperative hemorrhagic complications (HC). A first analysis was performed to compare the incidence of HC (grade 3 and 4 NCICTC) following CRS combined with HIPEC with oxaliplatin (HIPEC-Ox) versus HIPEC with other chemotherapy agents, in a selection of patients, analyzed in the annual report of the Association Française de Chirurgie published in 2008, and treated for colorectal PC, pseudomyxoma peritonei (PMP) and malignant peritoneal mesothelioma (MPM). A second analysis was performed to evaluate the prognostic factors of HC in patients treated with HIPEC-Ox for the same 3 malignancies in 3 French institutions (Centre Hospitalier Lyon-Sud (CHLS), Lyon; Hôpital Lariboisière (LH), Paris; Institut Gustave Roussy (IGR), Villejuif), between October 1998 and December 2012. ln the first part, there were 389 CRS combined with HIPEC-Ox and 316 procedures with ether cytotoxics (mitomycin C and cisplatin). The overall incidence of HC was 9.8/o and was significantly higher in the HIPEC-Ox group (15.7o/o vs. 2.5%, p13) had significantly more HC after HIPEC-Ox (p<0.01 and p