Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC).
<h4>Background</h4>Complete cytoreductive surgery with Hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment for patients with peritoneal metastases. In this retrospective observational two-center study, we assessed the impact of patient's body mass index (BMI)...
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Public Library of Science (PLoS)
2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0325941 |
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| author | Anne-Cécile Ezanno Olivier Poudevigne Jean-Louis Quesada Julio Abba Brice Malgras Bertrand Trilling Pierre-Yves Sage Juliette Fischer Marc Pocard Catherine Arvieux Fatah Tidadini |
| author_facet | Anne-Cécile Ezanno Olivier Poudevigne Jean-Louis Quesada Julio Abba Brice Malgras Bertrand Trilling Pierre-Yves Sage Juliette Fischer Marc Pocard Catherine Arvieux Fatah Tidadini |
| author_sort | Anne-Cécile Ezanno |
| collection | DOAJ |
| description | <h4>Background</h4>Complete cytoreductive surgery with Hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment for patients with peritoneal metastases. In this retrospective observational two-center study, we assessed the impact of patient's body mass index (BMI) on surgical and oncological outcomes.<h4>Methods</h4>Between 2017 and 2021, 144 patients with peritoneal metastases (all etiologies) were included. Morbi-mortality at day-30, overall survival and free-recurrence-survival were compared according to the patients BMI. The patients were divided into 2 groups (BMI < 25, and BMI ≥ 25).<h4>Results</h4>Median overall survival (OS) was 71.3 months [63-71.5], with significant differences observed between BMI groups (p = 0.015). Recurrence-free survival (RFS) averaged 26.8 months [20-35.3] and did not significantly differ between groups (p = 0.267). After stratification by histology, OS and RFS remained consistent. Cox multivariate analysis adjusted for Peritoneal Carcinomatosis Index (PCI) revealed BMI < 25 (HR = 2.53 [1.10-5.80]) and male sex (HR = 2.34 [1.11-4.92]) as predictors of poorer OS. 30-Day complication rates did not significantly differ (p = 0.094). The BMI ≥ 25 group experienced higher rates of digestive fistulas (p = 0.05) and 90-day readmissions (p = 0.007), although reintervention rates were comparable (p = 0.723).<h4>Conclusions</h4>Our study suggests a potential 'obesity paradox' in the context of HIPEC procedures. Morbidity at day-30 was similar for BMI < 25, and BMI ≥ 25 patients. Readmissions at day-90 were more frequent in high-BMI group. BMI < 25 is deleteriously associated with mortality. BMI and sex were related to OS. |
| format | Article |
| id | doaj-art-a82eb717683e4f78bf4ebb9eaef1b395 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-a82eb717683e4f78bf4ebb9eaef1b3952025-08-20T03:49:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032594110.1371/journal.pone.0325941Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC).Anne-Cécile EzannoOlivier PoudevigneJean-Louis QuesadaJulio AbbaBrice MalgrasBertrand TrillingPierre-Yves SageJuliette FischerMarc PocardCatherine ArvieuxFatah Tidadini<h4>Background</h4>Complete cytoreductive surgery with Hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment for patients with peritoneal metastases. In this retrospective observational two-center study, we assessed the impact of patient's body mass index (BMI) on surgical and oncological outcomes.<h4>Methods</h4>Between 2017 and 2021, 144 patients with peritoneal metastases (all etiologies) were included. Morbi-mortality at day-30, overall survival and free-recurrence-survival were compared according to the patients BMI. The patients were divided into 2 groups (BMI < 25, and BMI ≥ 25).<h4>Results</h4>Median overall survival (OS) was 71.3 months [63-71.5], with significant differences observed between BMI groups (p = 0.015). Recurrence-free survival (RFS) averaged 26.8 months [20-35.3] and did not significantly differ between groups (p = 0.267). After stratification by histology, OS and RFS remained consistent. Cox multivariate analysis adjusted for Peritoneal Carcinomatosis Index (PCI) revealed BMI < 25 (HR = 2.53 [1.10-5.80]) and male sex (HR = 2.34 [1.11-4.92]) as predictors of poorer OS. 30-Day complication rates did not significantly differ (p = 0.094). The BMI ≥ 25 group experienced higher rates of digestive fistulas (p = 0.05) and 90-day readmissions (p = 0.007), although reintervention rates were comparable (p = 0.723).<h4>Conclusions</h4>Our study suggests a potential 'obesity paradox' in the context of HIPEC procedures. Morbidity at day-30 was similar for BMI < 25, and BMI ≥ 25 patients. Readmissions at day-90 were more frequent in high-BMI group. BMI < 25 is deleteriously associated with mortality. BMI and sex were related to OS.https://doi.org/10.1371/journal.pone.0325941 |
| spellingShingle | Anne-Cécile Ezanno Olivier Poudevigne Jean-Louis Quesada Julio Abba Brice Malgras Bertrand Trilling Pierre-Yves Sage Juliette Fischer Marc Pocard Catherine Arvieux Fatah Tidadini Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC). PLoS ONE |
| title | Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC). |
| title_full | Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC). |
| title_fullStr | Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC). |
| title_full_unstemmed | Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC). |
| title_short | Impact of body mass index on surgical and oncological outcomes after Hyperthermic Intraperitoneal Chemotherapy (HIPEC). |
| title_sort | impact of body mass index on surgical and oncological outcomes after hyperthermic intraperitoneal chemotherapy hipec |
| url | https://doi.org/10.1371/journal.pone.0325941 |
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