Feasibility and safety of hyperthermic intra-peritoneal chemotherapy in patients with ovarian cancer and chronic kidney disease.

Objective: This study aimed to compare perioperative outcomes and progression-free and overall survival in patients with chronic kidney disease (CKD) versus those without after hyperthermic intra-peritoneal chemotherapy (HIPEC) for ovarian cancer.

Methods: This is a retrospective, single-institution cohort study of patients with ovarian cancer treated with HIPEC at the Cleveland Clinic from January 2009 to December 2022. All patients received HIPEC with cisplatin and renal protection with mannitol and furosemide. Patients with a documented pre-operative eGFR were included. CKD was defined as a pre-operative eGFR of <60 mL/min per 1.73 m. Demographics, clinicopathological data, perioperative creatinine levels, surgical complexity, post-operative complications, and treatment characteristics were analyzed. Progression-free and overall survival were assessed using Cox right-censored univariate models.

Results: Of 171 patients, 16.4% (n = 28) had CKD. No significant differences were found in post-operative acute kidney injury (21.4% with CKD vs 13.3% in those without; p = .15), readmission rates (10.7% CKD vs 11.9% in those without; p = .99), or major complications such as death, venous thromboembolism, myocardial injury, and sepsis (10.7% with CKD vs 11.9% in those without; p = .95). Both groups had a median hospital stay of 5 days (p = .65). There was also no significant difference in survival, with median progression-free survival of 15.5 months in the group with CKD versus 16.8 months in those without (p = .79) and overall survival of 58.4 months in those with CKD versus 39.3 months in those without (p = .33).

Conclusion: There was no significant difference in complication rates, progression-free survival, or overall survival between patients with CKD and those with normal kidney function receiving HIPEC for ovarian cancer.