THORACIC COMPLICATIONS IN PATIENTS UNDERGOING INTRAPERITONEAL HEATED CHEMOTHERAPY WITH MITOMYCIN FOLLOWING CYTOREDUCTIVE SURGERY

Background: The purpose of this study was to determine the incidence a nd severity of thoracic reactions in patients undergoing intraperitone al heated chemotherapy (IPHC). Methods: Forty-two patients who had int raperitoneal disseminated malignancies were treated with cytoreductive surgery (CS) and IPHC. The primary malignancies included carcinoma of the colon (n = 17), stomach (n = 6), appendix (n = 6), pseudomyxoma p eritonei (n = 3), mesothelium (n = 2), ovaries (n = 2), jejunum (n = 2 ), gallbladder (n = 1), urachus (n = 1), and peritoneal carcinomatosis In = 2). After CS, IPHC with mitomycin (MMC) was administered by perf usion at 40.5 degrees C. After IPHC, multiple radiographs of the chest were reviewed in comparison to the control group. Results: Thoracic c omplications occurred in 36 patients (86%), including atelectasis in 3 2 patients (76%), pleural effusions in 27 (64%), pulmonary edema in 10 (24%), pneumonia in 2 (5%), and pneumothorax in 2 (5%). The incidence of thoracic complications in the IPHC group was significantly higher than that of patients in the control group (P <.05). Correlations betw een the prevalence of pleural effusion and the dose of MMC, duration o f procedure, and presence of thrombocytopenia were not significant (P >.05). Conclusions: Bibasilar atelectasis and pleural effusions are co mmon findings after IPHC with MMC, but most of them do not necessarily warrant intervention. (C) 1997 Wiley-Liss, Inc.