This study aimed to explore the perioperative safety of radical resection combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment and prevention of peritoneal metastasis in patients with advanced colorectal cancer.

This study retrospectively analyzed 123 patients with radical surgery + HIPEC locally advanced colorectal cancer in the Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2020 to February 2021. The perioperative safety of patients with advanced colorectal cancer was evaluated according to common terminology criteria for adverse events (CTCAE 5.0) published by the US Department of Public Health. We analyzed the independent risk factors of adverse events in patients with locally advanced colorectal cancer through the logistics model.

All 123 patients underwent radical resection + HIPEC treatment. A total of 45 cases (36.6%) of advanced colorectal cancer patients had adverse events of grade 2 and above after surgery. The average postoperative hospital stay was (11.7±4.30) days. The difference analysis of the incidence of adverse events in patients undergoing 1~3 times of HIPEC showed that there was a significant difference in the incidence of gradeⅡbone marrow suppression (χ²=7.303, P=0.012). Univariate and multivariate logistics analysis showed that women (OR=3.280, 95%CI: 1.355~7.939, P=0.007) was an independent risk factor for adverse events in locally advanced colorectal cancer patients treated with HIPEC after radical surgery, while 18.5 kg/m²≤BMI≤24.0 kg/m² was an independent protective factor (OR=0.155, 95%CI: 0.041~0.587, P=0.011).

Radical surgery combined with HIPEC in the treatment of advanced colorectal cancer patients did not significantly increase the incidence of common postoperative complications. However, the second-degree myelosuppression of advanced colorectal cancer patients who received 3 times of HIPEC during the perioperative period was significantly higher than that of 1~2 times. Meanwhile, clinicians should pay close attention to the incidence of adverse events in women or advanced colorectal cancer patients with low (or high) BMI undergoing radical resection combined with HIPEC treatment.