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Does Hospital Operative Volume Influence the Outcomes of Patients After Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis?

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

For some cancer operations, center volume is associated with improved patient outcomes. Whether this association is true for cytoreductive surgery/heated intraperitoneal chemotherapy (CRS/HIPEC) is unclear. Given the rapidly expanding use of CRS/HIPEC, the aim of this analysis was to determine whether a volume-outcome relationship exists for this strategy.

Methods

The Vizient Clinical Database® was queried for CRS/HIPEC cases from January 2020 through December 2022. Low-, medium-, and high-volume designations were made by sorting hospitals by case volume and creating equal tertiles based on total number of cases. Analysis was performed via one-way ANOVA with post-hoc Tukey test, as indicated.

Results

In the 36-month study period, 5165 cases were identified across 149 hospitals. Low- (n = 113), medium- (n = 25), and high-volume (n = 11) centers performed a median of 4, 21, and 47 cases per annum, respectively. Most cases were performed for appendiceal (39.3%) followed by gynecologic neoplasms (20.4%). Groups were similar with respect to age, gender, race, comorbidities, and histology. Low-volume centers were more likely to utilize the ICU post-operatively (59.6% vs. 40.5% vs. 36.3%; p = 0.02). No differences were observed in morbidity (9.4% vs. 7.1% vs. 9.0%, p = 0.71), mortality (0.9% vs. 0.6% vs. 0.7%, p = 0.93), length of stay (9.3 vs. 9.4 vs. 10 days, p = 0.83), 30-day readmissions (5.6% vs. 5.6% vs. 5.6%, p = 1.0), or total cost among groups.

Conclusions

No association was found between CRS/HIPEC hospital volume and post-operative outcomes. These data suggest that in academic medical centers with HIPEC programs, outcomes for commonly treated cancers are not associated with hospital volume.

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Authors and Affiliations

  1. Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Praveen D. Chatani MD, Alexander Manzella MD, Yelizaveta Y. Gribkova BA, Toni Beninato MD, Timothy Kennedy MD, Henry A. Pitt MD & Henry Richard Alexander MD

  2. Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Brett L. Ecker MD, Toni Beninato MD, Timothy Kennedy MD, Henry A. Pitt MD & Henry Richard Alexander MD

Authors
  1. Praveen D. Chatani MD
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  2. Alexander Manzella MD
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  3. Yelizaveta Y. Gribkova BA
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  4. Brett L. Ecker MD
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Correspondence to Henry A. Pitt MD or Henry Richard Alexander MD.

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Chatani, P.D., Manzella, A., Gribkova, Y.Y. et al. Does Hospital Operative Volume Influence the Outcomes of Patients After Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis?. Ann Surg Oncol 31, 1049–1057 (2024). https://doi.org/10.1245/s10434-023-14450-y

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