Short-Term Postoperative Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Pilot Study.

OBJECTIVES

To assess the association between short-term postoperative cognitive dysfuction (POCD) and inflammtory response in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

DESIGN

A prospective cohort study.

SETTING

University medical centre.

PARTICIPANTS

Fifty-one adult patients who had undergone CRS-HIPEC and twenty control participants.

MEASUREMENTS

The inflammatory marker levels in plasma and cognitive function were measured.

RESULTS

Twenty (39.2%, 20/51) patients developed POCD at 1 w after CRS-HIPEC. The patients with POCD had higher serum interleukin 1 (IL-1), serum amyloid A (SAA), S100 calcium-binding protein (S-100), and high mobility group box-1 protein (HMGB-1) levels at 1 and 24 h postoperatively than patients without POCD. There was an association between POCD and the maximum IL-1 and S-100 concentrations in serum, which remained following adjustment for age and FBS.

CONCLUSION

In this pilot study, perioperative inflammatory marker levels increase significantly after CRS-HIPEC in adult patients, and such elevations are associated with the development of short-term cognitive dysfunction after this complex surgery. These results suggested the need for a larger RCT to replicate and confirm these findings.