Comparison of MRI and CT for Predicting the Peritoneal Cancer Index (PCI) Preoperatively in Patients Being Considered for Cytoreductive Surgical Procedures

Low, Russell N.; Barone, Robert M.; Lucero, Janelle

doi:10.1245/s10434-014-4041-7

Cited by 166 publications

(142 citation statements)

References 16 publications

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“…Among these, 499 patients from 8 studies have homogenous clinical characteristics and represent the most homogenous population, on which conclusions can be drawn with a higher level of interest. In this population, the median overall survival is 37.3 months (range 27-78), the median disease-free survival is 14.4 months (range [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], and the median 5-year overall survival is 40% (range .…”

Section: Topic 6: What Is the Best Timing As Far As Results Are Concementioning

confidence: 99%

1^st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

Cavaliere

Cirocchi

Catena

et al. 2017

Tumori

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Ovarian cancer (OC) remains relatively rare, although it is among the top 4 causes of cancer death for women younger than 50. The aggressive nature of the disease and its often late diagnosis with peritoneal involvement have an impact on prognosis. The current scientific literature presents ambiguous or uncertain indications for management of peritoneal carcinosis (PC) from OC, both owing to the lack of sufficient scientific data and their heterogeneity or lack of consistency. Therefore, the Italian Society of Surgical Oncology (SICO), the Italian Society of Obstetrics and Gynaecology, the Italian Association of Hospital Obstetricians and Gynaecologists, and the Italian Association of Medical Oncology conducted a multidisciplinary consensus conference (CC) on management of advanced OC presenting with PC during the SICO annual meeting in Naples, Italy, on September 10-11, 2015. An expert committee developed questions on diagnosis and staging work-up, indications, and procedural aspects for peritonectomy, systemic chemotherapy, and hyperthermic intraperitoneal chemotherapy for PC from OC. These questions were provided to 6 invited speakers who answered with an evidence-based report. Each report was submitted to a jury panel, representative of Italian experts in the fields of surgical oncology, gynecology, and medical oncology. The jury panel revised the reports before and after the open discussion during the CC. This article is the final document containing the clinical evidence reports and statements, revised and approved by all the authors before submission.

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Section: Topic 6: What Is the Best Timing As Far As Results Are Concementioning

confidence: 99%

1^st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

Cavaliere

Cirocchi

Catena

et al. 2017

Tumori

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“…Preoperative MRI and CT of the abdomen and pelvis play a critical role in the assessment of the extent of peritoneal and visceral disease in patients being considered for CRS and HIPEC for CPM [48]. In comparison with CT, MRI uses different types of image contrast to create images that are more sensitive for detection of peritoneal lesions [49–51].…”

Section: Controversial Issues and Latest Progressmentioning

confidence: 99%

“…With major refinements in hardware and software, functional MRI such as diffusion-weighted MRI (DWI) has become technically possible. Various tumors actuate restricted diffusion of water protons which can be evaluated by DWI, resulting in an area of altered signal on DWI [48]. The sensitivity of DWI for depicting peritoneal tumor has opened the gate to potential advancements in detecting disseminated peritoneal metastatic disease.…”

Section: Controversial Issues and Latest Progressmentioning

confidence: 99%

Multidisciplinary Treatment for Colorectal Peritoneal Metastases: Review of the Literature

Cai

2016

Gastroenterology Research and Practice

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Peritoneum is one of the common sites of metastasis in advanced stage colorectal cancer patients. Colorectal cancer patients with peritoneal metastases (PM) are traditionally believed to have poor prognosis, which indicates it is of no value to adopt surgical treatment. With the advancement of surgical techniques, hyperthermic intraperitoneal chemotherapy (HIPEC), and multidisciplinary treatment in recent years, the cognition and treatment strategies of colorectal peritoneal metastases (CPM) have changed dramatically. In terms of prognosis, CPM under the palliative systemic treatment shows an inferior outcome compared with nonperitoneal metastasis. Nevertheless, some CPM patients amenable to the complete peritoneal cytoreductive surgery (CRS) combined with HIPEC may achieve long-term survival. The prognostic factors of CPM comprise peritoneal carcinomatosis index (PCI), completeness of cytoreduction score (CC score), the presence of extraperitoneal metastasis (liver, etc.), Peritoneal Surface Disease Severity Score (PSDSS), Japanese peritoneal staging, and so forth. Taken together, literature data suggest that a multimodality approach combining complete peritoneal CRS plus HIPEC, systemic chemotherapy, and targeted therapy may be the best treatment option for PM from colorectal cancer.

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“…Jiang et al validate a novel tool to measure QOL in patients undergoing isolated limb infusion procedures. 10 Three articles (by Tohme et al, 11 Low et al, 12 and Baumgartner et al. 13 ) are important as they demonstrate the advances being made in the field to better predict our failures.…”

mentioning

confidence: 99%

“…11 The second looks at the utility of novel imaging with magnetic resonance technology to predict more accurately the peritoneal burden of disease. 12 The third looks at predictors of progression after CRS?HIPEC and found that nodal disease was likely the most significant factor. Innovative approaches to the management of patients with peritoneal disease are highlighted further.…”

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confidence: 99%

Moving Fast and Moving Slow

et al. 2015

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The Ninth International Symposium on Regional Therapies at Steamboat Springs, Colorado brought forth some of the finest research occurring in the management of advanced malignancies. We are pleased to present some of this work in the Annals of Surgical Oncology. Although it is difficult to do justice to the perseverance of the teams, the investigation of the scientists, and the sacrifices of our patients in a few pages, we hope to provide you with a snapshot of a rapidly changing field. Delivering cytotoxic therapy in a proinflammatory healing state after an operation requires the development of a precise frameworkthe hallmark of regional therapies. Advancement of care has required rapid intuitive thinking and development of surgical concepts that have allowed us to apply selective regional therapies to patients more widely than ever before. It is estimated that more than 1,300 cytoreductive procedures and hyperthermic intraperitoneal chemotherapy (HIPEC) procedures were performed in the United States in 2012, and the numbers are increasing. The rapid pace of these advances has brought with it careful investigation of the aspects of care, focusing on oncological outcomes, safety, and patient-centered metrics. These developments have been associated with the growth of new centers both locally and internationally, thereby improving access to care.The articles from the Symposium explore the application of aggressive surgical resection in the setting of chemoperfusion. Randle et al. studied 108 patients from a prospective database of 1,067 patients who underwent hepatic resection concomitantly with cytoreductive surgery (CRS) and HIPEC.1 After establishing two groups-one with patients who underwent surface resection alone versus the other in which the patients were subjected to parenchymal resection-they found that the perioperative morbidity and mortality rates were similar. The overall survival for the group with colorectal cancer and peritoneal and hepatic metastases was 21.2 months. In a separate analysis, the authors examined 89 patients with diaphragmatic involvement who underwent CRS and HIPEC. In contrast to their previous report, the authors found that morbidity associated with the surgery was seen at a significantly higher rate among those undergoing diaphragmatic resection, especially in patients who required resection of fewer than five organs. 2Distribution of peritoneal disease often leads to involvement of the splenic hilum, necessitating distal pancreatectomy. Doud et al. reported on 63 patients who underwent distal pancreatectomy with a 30 % major morbidity rate and a significantly longer hospital stay than those that did not.3 Further adding to the evidence regarding the risks of a distal pancreatectomy, Downs-Canner et al. compared patients undergoing distal pancreatectomy with and without intraperitoneal chemotherapy. 4 They found that although the number of patients developing pancreatic fistulas was similar the morbidity associated with the fistulas was greater. In addition, the development of ...

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Comparison of MRI and CT for Predicting the Peritoneal Cancer Index (PCI) Preoperatively in Patients Being Considered for Cytoreductive Surgical Procedures

Abstract: MRI more accurately predicts PCI preoperatively in patients undergoing evaluation for cytoreductive surgery.

Cited by 166 publications

References 16 publications

1^st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

1^st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

Multidisciplinary Treatment for Colorectal Peritoneal Metastases: Review of the Literature

Moving Fast and Moving Slow

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Comparison of MRI and CT for Predicting the Peritoneal Cancer Index (PCI) Preoperatively in Patients Being Considered for Cytoreductive Surgical Procedures

Abstract: MRI more accurately predicts PCI preoperatively in patients undergoing evaluation for cytoreductive surgery.

Cited by 166 publications

References 16 publications

1st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

1st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

Multidisciplinary Treatment for Colorectal Peritoneal Metastases: Review of the Literature

Moving Fast and Moving Slow

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1^st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

1^st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer