Short-Term Effects of Hyperthermic Intraperitoneal Chemotherapy on Patients Following Cytoreductive Surgery: Retrospective Analysis From a Tertiary Care Center in Saudi Arabia

Introduction Cytoreductive surgery (CRS) with the use of hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard of treatment for peritoneal surface malignancy. Increasing evidence demonstrates the survival benefit of CRS combined with HIPEC, with the completion of cytoreduction being a key factor in prognosis. This study aimed to evaluate the impact of HIPEC on short-term postoperative outcomes in patients undergoing CRS and to assess factors associated with postoperative morbidity. Methods This retrospective cohort study was conducted using a maintained database of patients with peritoneal surface malignancies who underwent CRS with and without HIPEC at a tertiary care center in Riyadh, Saudi Arabia, from January 1, 2021, to November 1, 2024. Results A total of 95 patients were included, 52 of whom underwent CRS alone and 43 received CRS combined with HIPEC. Demographic and clinical characteristics were largely similar between groups; however, patients who underwent CRS and HIPEC had higher preoperative albumin levels (p = 0.007) and more frequent previous surgeries (p = 0.020). Operative time was significantly longer in the CRS and HIPEC group (p < 0.001), and stoma creation was more common (p = 0.014). Overall, postoperative complications were fewer in the CRS and HIPEC group. The 30-day mortality rate was 0% for both groups, and the Peritoneal Cancer Index (PCI) was the only predictor of severe complications (p = 0.047). Conclusion Complete cytoreduction remains the standard in the treatment of peritoneal surface malignancies to maximize survival potential. The addition of HIPEC does not appear to increase short-term postoperative outcomes, while disease burden, as reflected by the PCI, remains the primary independent determinant of postoperative risk.