Impact of immunonutrition on inflammatory and nutritional biomarkers in perioperative HIPE
DOI:
https://doi.org/10.66154/nmetj.v2i1.19Keywords:
Immunonutrition, HIPEC, Inflammation, Albumin, C-reactive proteinAbstract
Objective: To evaluate C-reactive protein (CRP) and albumin behavior in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) receiving immunonutrition. Methods: Retrospective observational cohort of nine patients with peritoneal carcinomatosis (2021–2024). Biomarkers were assessed at five perioperative time points. Normality was tested using Shapiro-Wilk. Spearman correlation and nonparametric tests were applied. Results: CRP peaked 48h after HIPEC, while albumin decreased during the same period. Preoperative CRP variation showed positive correlation with complications (R²=0.542; p=0.156). Discharge BMI correlated negatively with complications (r=-0.66). Conclusion: HIPEC induces severe metabolic stress reflected by inflammatory and nutritional biomarkers. Dynamic monitoring of these markers may support early identification of patients at higher risk of postoperative complications.
References
McQuade C, Renton M, Chouhan A, et al. Review of imaging peritoneal disease and treatment. Can Assoc Radiol J. 2024;0(0):08465371241296778. doi:10.1177/08465371241296778.
Torres EM. Peritoneal tumors of Mullerian origin: a case report and review of the literature. Int J Med Sci Clin Res Stud. 2022;2(11):1598-1601. doi:10.47191/ijmscrs/v2-i11-16.
Cortés-Guiral D, Cascales-Campos PA, Sugarbaker PH, et al. Primary and metastatic peritoneal surface malignancies. Nat Rev Dis Primers. 2021;7(1):50. doi:10.1038/s41572-021-00326-6.
Sarvestani AL. Malignant peritoneal mesothelioma literature review: past, present, and future. Diagnostic and Interventional Research. 2022;2(4):30. doi:10.21037/dmr-22-19.
Rubio-López J, Durán-Martínez M, Moreno-Blázquez A, et al. Intraoperative metabolic changes associated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Langenbecks Arch Surg. 2023;408(1):31. doi:10.1007/s00423-023-02770-2.
Valencia-Sola L, Becerra-Bolaños Á, Mateo-Ferragut M, et al. Cytoreductive Surgery (CS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Postoperative Evolution, Adverse Outcomes and Perioperative Risk Factors. Healthcare (Basel). 2025;13(7):808. doi:10.3390/healthcare13070808.
Guven D, Şahin T, Erul E, et al. The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Front Mol Biosci. 2022;9:1039121. doi:10.3389/fmolb.2022.1039121.
Adiamah A, Skořepa P, Weimann A, et al. The Impact of Preoperative Immune Modulating Nutrition on Outcomes in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis. Ann Surg. 2019;270(2):247-56. doi:10.1097/SLA.0000000000003256.
García-Malpartida K, Aragón-Valera C, Botella-Romero F, et al. Effects of Immunonutrition on Cancer Patients Undergoing Surgery: A Scoping Review. Nutrients. 2023;15(7):1776. doi:10.3390/nu15071776.
Raczyńska A, Leszczyńska T, Skotnicki P, et al. The Impact of Immunomodulatory Components Used in Clinical Nutrition—A Narrative Review. Nutrients. 2025;17(5):752. doi:10.3390/nu17050752.
Tan G, Chia C, Wong J, Ong W, Zhu H, Ong C, Teo M. Randomized controlled trial investigating perioperative immunonutrition for patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Ann Surg Oncol. 2023;30:777-789. doi:10.1245/s10434-022-12509-w.
Thorgersen E, Asvall J, Frøysnes I, Schjalm C, Larsen S, Dueland S, Andersson Y, Fodstad Ø, Mollnes T, Flatmark K. Increased local inflammatory response to MOC31PE immunotoxin after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol. 2021;28:5252-5262. doi:10.1245/s10434-021-10022-0..
Elias D, Glehen O, Gilly F, et al. Carcinose peritoneal de origem digestiva e primitiva. In: Relatório do 110º Congresso da AFC. Paris: Arnette: Wolters Kluwer França; 2008. p. 23-30.
Sugarbaker PH. Procedimentos de peritonectomia. Surg Oncol Clin N Am. 2003;12(4):703-27. doi:10.1016/S1055-3207(03)00048-6.
Fugolar F, Hacke A, Polakowski C, et al. Relação do índice de risco nutricional com complicações pós-operatórias de cirurgias do sistema digestório em um hospital oncológico. Nutr Clín Diet Hosp. 2016;36(4):119-24. doi:10.12873/364fugolar.
Guven D, Şahin T, Erul E, et al. The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Front Mol Biosci. 2022;9:1039121. doi:10.3389/fmolb.2022.1039121.
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nutrition and Metabolism Journal: Clinical and Experimental
This work is licensed under a Creative Commons Attribution 4.0 International License.
