Neutropenia in colorectal cancer treated with oxaliplatin-based hyperthermic intraperitoneal chemotherapy: An observational cohort study

Table 1 Demographics and patient characteristics

	Neutropenia, n = 32	No neutropenia, n = 214	P value	Whole cohort, n = 246
Age (yr), mean ± SD	60 ± 11	55 ± 13	0.048	55 ± 14
Gender, n (%)			0.12
Male	18 (56)	93 (43)		111 (45)
Female	14 (44)	121 (57)		135 (55)
Primary tumour, n (%)			0.79
Colon	30 (94)	189 (88)		219 (89)
Rectum	2 (6)	24 (11)		26 (11)
Colorectal unspecified	0 (0)	1 (1)		1 (< 1)
PM disease, n (%)			0.021
Synchronous	23 (72)	107 (50)		115 (52)
Metachronous	9 (28)	107 (50)		106 (48)
Missing data	0 (0)	0 (0)		1 (< 1)
Neoadjuvant for PM disease, n (%)	23 (72)	100 (47)	0.035	123 (50)
Node positive primary, n (%)	19 (59)	154 (72)	0.048	173 (70)
Missing data	4 (12)	5 (2)		9 (4)
Differentiation, n (%)			0.4
Poor	10 (31)	56 (26)		66 (27)
Moderat/high	20 (62)	149 (70)		169 (79)
Missing data	2 (9)	9 (4)		11 (4)
PCI, mean ± SD	15.4 ± 10	12.1 ± 8	0.043	12.5 ± 9
Liver metastases, n (%)	4 (12)	32 (15)	0.7	36 (15)
CC score, n (%)			0.31
0	28 (88)	194 (91)		222 (90)
1	2 (6)	15 (7)		17 (7)
2	2 (6)	3 (1)		5 (2)
3	0 (0)	2 (1)		2 (1%)
HIPEC, n (%)			< 0.0001
Oxaliplatin	11 (34)	187 (87)		198 (80)
Oxali + irinotecan	21 (66)	27 (13)		48 (20)
HIPEC dose reduction, n (%)	9 (28)	26 (12)	0.07	35 (14)
Missing data	14 (44)	53 (25)		67 (27)
EPIC administration, n (%)	6 (19)	18 (8)	0.0001	24 (10)
Operating time, mean ± SD	552 ± 129	461 ± 123	0.55	473 ± 127
Return to OR postop, n (%)	2 (6)	24 (11)	0.1	26 (11)
Clavien-Dindo grade 3-4, n (%)	6 (19)	67 (31)	0.18	73 (30)
Postop in-hospital mortality	1 (3)	3 (2)		4 (2)
Adjuvant chemotherapy, n (%)			0.13
Yes	14 (44)	113 (53)		127 (52)
No	18 (56)	92 (43)		110 (45)
Missing data	0 (0)	9 (4)		9 (3)
CEA – median (range)	4 (1-61)	6.5 (0-593)	0.048	5 (0-593)

PM: Peritoneal metastases; PCI: Peritoneal cancer index; SD: Standard deviation; CC: Completeness of cytoreduction; HIPEC: Hyperthermic intraperitoneal chemotherapy; EPIC: Early postoperative intraperitoneal chemotherapy; OR: Operating room; CEA: Carcinoembryonic antigen.

Table 2 Univariate and multivariate Cox proportional regression analysis with disease-free survival as endpoint

	Univariate, hazard ratio	P value	Multivariate, hazard ratio	P value
Age (yr)	1.00 (CI: 0.99-1.01)	0.7
Gender male/female (n)	1.19 (CI: 0.89-1.59)	0.2
Colon/Rectum	0.81 (CI: 0.11-5.77)	1.0
Synchronous/metachronous	0.90 (CI: 0.68-1.20)	0.49
Neoadjuvant for PM disease	1.06 (CI: 0.79-1.41)	0.7
Node positive disease primary	1.16 (CI: 0.83-1.61)	0.52
Poor differentiation	1.08 (CI: 0.78-1.49)	0.82
PCI	1.03 (CI: 1.01-1.04)	0.0005	1.02 (CI: 1.00-1.04)	0.033
Liver metastases	1.56 (CI: 1.06-2.30)	0.02	1.52 (CI: 1.03-2.25)	0.016
CC score 0 vs 1-3	1.91 (CI: 1.36-2.67)	0.0001	1.66 (CI: 1.12-2.46)	0.011
EPIC administration	0.92 (CI: 0.56-1.50)	0.73
OX HIPEC; OXIRI HIPEC	Reference 0.74 (0.51-1.07)	0.11
Operating time	1.00 (CI: 1.00-1.00)	0.04	1.00 (CI: 1.00-1.00)	0.25
Any-grade neutropenia	0.61 (CI: 0.38-0.98)	0.02	0.58 (CI: 0.36-0.95)	0.031
Adjuvant chemotherapy given	1.07 (CI: 0.80-1.44)	0.37

PM: Peritoneal metastases; PCI: Peritoneal cancer index; CC: Completeness of cytoreduction; EPIC: Early postoperative intraperitoneal chemotherapy; HIPEC: Hyperthermic intraperitoneal chemotherapy; OX: Oxaliplatin; IRI: Irinotecan.