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 β (IL-1 β ), serum amyloid A (SAA), S100 calcium-binding protein β (S-100 β ), 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 β and S-100 β 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.