Adoption of cytoreductive surgery in the management of peritoneal malignancies—Global trends

Sedighim, Shaina; Khan, Aaqil; Li, Amy Y.; Tajik, Fatemeh; Radhakrishnan, Vinodh K.; Eng, Oliver; Turaga, Kiran; Senthil, Maheswari

doi:10.1002/jso.27448

Journal of Surgical Oncology

2023

DOI: 10.1002/jso.27448

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Adoption of cytoreductive surgery in the management of peritoneal malignancies—Global trends

Shaina Sedighim,

Aaqil Khan,

Amy Y. Li

et al.

Abstract: Cytoreductive surgery (CRS) has now been accepted as an integral component in the management of gastrointestinal and gynecological cancers with peritoneal metastases. Since the adoption of CRS is influenced by access to advanced medical facilities, trained multidisciplinary teams, and funding, there is wide variability in incorporation of CRS into routine clinical practice between high‐ versus low‐ and middle‐income countries. This review highlights the global trends in the adoption of CRS for peritoneal malig… Show more

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Elevating standards: A comprehensive model for peritoneal surface malignancy management in developing healthcare systems

Souadka,

Boutayeb,

El Khannoussi

et al. 2023

Journal of Surgical Oncology

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income countries (LMICs) in implementing comprehensive peritoneal malignancy programs. They rightly emphasized factors influencing the adoption of cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy, including access to a multidisciplinary team proficient in peritoneal malignancy, the learning curve of surgeons and staff, perioperative support, funding mechanisms, awareness, education about the benefits of CRS, and social barriers.

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Elevating standards: A comprehensive model for peritoneal surface malignancy management in developing healthcare systems

Souadka,

Boutayeb,

El Khannoussi

et al. 2023

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Building an Efficient Peritoneal Surface Malignancies Program Despite the Lower-Middle–Income Barriers: Ukraine Experience

Kopetskyi,

Antoniv,

Yarema

et al. 2024

JCO Glob Oncol

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PURPOSE Cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) programs are often limited to centers in developed countries because of extensive requirements. We aimed to analyze efficacy and challenges of CRS/HIPEC centers in lower-middle–income settings in the Ukraine example. METHODS A multicenter descriptive study was conducted using data sets (2008-2022) from Kyiv, Lviv, and Odesa centers. Patients with appendiceal neoplasm (AN); colorectal cancer (CRC); malignant peritoneal mesothelioma (MPM); and epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC) treated with CRS ± HIPEC were included. Overall survival (OS) was analyzed for N ≥ 20 cohorts using the Kaplan-Meier method. RESULTS We included 596 patients. At Kyiv and Lviv centers, 37 and 28 patients with AN had completeness of cytoreduction (CC-0/1) rates of 84% and 71%, respectively. Thirty-day major morbidity stood at 24% and 18%, respectively. Median OS was not reached (NR) at both centers. Nineteen patients with CRC from Kyiv, 11 from Lviv, and 156 from Odesa had CC‐0/1 rates of 84%, 91%, and 86%, respectively. Thirty-day major complications occurred in 16%, 18%, and 8%, respectively. Median OS in the Odesa cohort was 35 (95% CI, 32 to 38) months. Among 15 Kyiv, five Lviv, and six Odesa patients with MPM, CC‐0/1 rates were 67%, 80%, and 100%, respectively, while major complications occurred in 13%, 0%, and 17%, respectively. OS was not analyzed because of small MPM cohorts. At Kyiv, Lviv, and Odesa centers, 91, 40, and 89 patients, respectively, had primary EOC. CC-0/1 rates were 79%, 100%, and 80%, and 30-day major morbidity rates were 23%, 5%, and 6%, respectively. Median OS was NR, 71 (95% CI, 32 to 110), and 67 (95% CI, 61 to 73) months, respectively. CONCLUSION CRS/HIPEC programs in lower-middle–income environment can achieve safety and survival that meet global standards. Our discussion highlights common obstacles in such settings and proposes effective overcoming strategies.

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Adoption of cytoreductive surgery in the management of peritoneal malignancies—Global trends

Cited by 2 publications

References 62 publications

Elevating standards: A comprehensive model for peritoneal surface malignancy management in developing healthcare systems

Elevating standards: A comprehensive model for peritoneal surface malignancy management in developing healthcare systems

Building an Efficient Peritoneal Surface Malignancies Program Despite the Lower-Middle–Income Barriers: Ukraine Experience

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