November 29, 2025
Objective: This study aimed to compare perioperative outcomes and progression-free and overall survival in patients with chronic kidney disease (CKD) versus those without after hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer.
Methods: This retrospective, single-institution cohort study included patients with ovarian cancer treated with HIPEC at the Cleveland Clinic between January 2009 and December 2022. All patients received HIPEC with cisplatin and renal protection using mannitol and furosemide. Patients with a documented preoperative estimated glomerular filtration rate (eGFR) were included. CKD was defined as a preoperative eGFR of less than 60 mL/min/1.73 m². Demographic, clinicopathologic, perioperative creatinine, surgical complexity, postoperative complication, and treatment data were analyzed. Progression-free survival and overall survival were evaluated using Cox right-censored univariate models.
Results: Among 171 patients, 16.4% (n = 28) had CKD. No significant differences were observed in postoperative acute kidney injury (21.4% in the CKD group vs. 13.3% in the non-CKD group; p = .15), readmission rates (10.7% vs. 11.9%; p = .99), or major complications including death, venous thromboembolism, myocardial injury, and sepsis (10.7% vs. 11.9%; p = .95). Both groups had a median hospital stay of 5 days (p = .65). There were also no significant differences in survival outcomes. Median progression-free survival was 15.5 months in patients with CKD versus 16.8 months in those without CKD (p = .79), while median overall survival was 58.4 months versus 39.3 months, respectively (p = .33).
Conclusion: There were no significant differences in complication rates, progression-free survival, or overall survival between patients with CKD and those with normal kidney function undergoing HIPEC for ovarian cancer.
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