Is There a Possibility of a Cure in Patients With Colorectal Peritoneal Carcinomatosis Amenable to Complete Cytoreductive Surgery and Intraperitoneal Chemotherapy?

Goèré, Diane; Malka, David; Tzanis, Dimitri; Gava, Vinícius Grando; Boige, Valérie; Eveno, Clarisse; Maggiori, Léon; Dumont, Frédéric; Ducreux, Michel; Élias, Dominique

doi:10.1097/sla.0b013e31827e9289

Cited by 237 publications

(108 citation statements)

References 45 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…Elias et al have demonstrated a cure rate (16%) after complete CRS of colorectal peritoneal carcinomatosis, followed by intraperitoneal chemotherapy in selected patients is close to that obtained after resection of colorectal liver metastases [1].…”

Section: Discussionmentioning

confidence: 99%

“…Cytoreductive surgery and HIPEC provides an important chance of long term survival in patients with peritoneal spread of colorectal cancer [1,11].…”

Section: Discussionmentioning

confidence: 99%

“…Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is now a common treatment for pseudomyxoma peritonei (PMP), malignant mesothelioma, peritoneal carcinomatosis (PC) from colorectal cancer (CRC) and appendiceal carcinoma, currently supported by survival, morbidity and mortality data [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Avoidance of Early Post-Operative Intraperitoneal Chemotherapy (EPIC) Following Peritonectomy with Heated Intraperitoneal Chemotherapy (HIPEC) Significantly Reduces Cost and Hospital Stay

Kirby¹,

Zhao²,

Chua³

et al. 2014

TOSOJ

View full text Add to dashboard Cite

Abstract:Aims: Peritoneal carcinomatosis is treated with Cytoreductive surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) with or without Early Postoperative Intraperitoneal Chemotherapy (EPIC) depending on the pathology involved. Since 2010 heated intraperitoneal oxaliplatin has been utilised in our institution. Our aim was to determine if there was a significant cost difference between patients receiving oxaliplatin and those requiring five additional days of EPIC. Methods:We retrospectively analysed 30 patients from our database. 15 patients underwent cytoreductive surgery, heated intraperitoneal oxaliplatin (350mg/m 2 ) and 5-fluorouracil (FU) intravenously administered intraoperatively. We compared those patients with 15 patients who underwent CRS, heated intraperitoneal mitomycin C (10-25mg/m 2 ) as well as EPIC with 5-FU (600-800mg/m 2 ) on postoperative days 1 to 5. Patients were matched for age, gender, pathology and peritoneal carcinomatosis index (PCI).Results: There was no significant difference between radiology (p=0.6) and transfusion costs (p=0.4). The chemotherapy costs in the oxaliplatin group were significantly higher (p=0.001) however overall bed costs including ward, HDU and ICU were significantly lower in the oxaliplatin group (p 0.029). There was a higher percentage of patients in the EPIC group that had postoperative ileus (p 0.4), rate of infection (p 0.1), fistula formation (p 0.03), return to theatre (p 0.2) and collection formation (p 0.07) compared to the oxaliplatin group. The overall cost was significantly lower in the oxaliplatin group (p 0.038). There was no significant survival benefit between both groups (p 0.3). Conclusion:In colorectal cancer the cost and complications of EPIC following HIPEC are unjustified. We now use oxaliplatin HIPEC as our standard regimen in colorectal cancer and appendiceal adenocarcinoma.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Cytoreductive surgery and HIPEC provides an important chance of long term survival in patients with peritoneal spread of colorectal cancer [1,11].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Avoidance of Early Post-Operative Intraperitoneal Chemotherapy (EPIC) Following Peritonectomy with Heated Intraperitoneal Chemotherapy (HIPEC) Significantly Reduces Cost and Hospital Stay

Kirby¹,

Zhao²,

Chua³

et al. 2014

TOSOJ

View full text Add to dashboard Cite

show abstract

“…Some suggest that 20 is a limit over which the surgical approach should be excluded [71]. Yet even if the Uppsala group report that treatment for high-volume peritoneal disease (PCI >20) seldom results in long-term survival [72], in their multivariate analysis Goéré et al found as the only independent factor predicting cure a PCI of 10 or less (73): the median PCI in long-term survivors was 4, a value we rarely find in our clinical practice.…”

Section: Proactive Management Of Peritoneal Metastases From Colorectamentioning

confidence: 98%

Proactive Management for Gastric, Colorectal and Appendiceal Malignancies: Preventing Peritoneal Metastases with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Sammartino

Biacchi

Cornali

et al. 2016

Indian J Surg Oncol

View full text Add to dashboard Cite

An integrated treatment strategy using peritonectomy procedures plus hyperthermic intraperitoneal chemotherapy (HIPEC) is now a clinical standard of care in selected patients with peritoneal metastases and primary peritoneal tumors. This comprehensive approach can offer many patients, who hitherto had no hope of cure, a good quality of life and survival despite limited morbidity. The increasingly successful results and chance of interfering in the natural history of disease has prompted research to develop for some clinical conditions a therapeutic strategy designed to prevent malignant peritoneal dissemination before it becomes clinically evident and treat it microscopically (tertiary prevention). The main factor governing successful cytoreductive surgery and predicting outcome is the extent of peritoneal spread assessed with the peritoneal cancer index (PCI). In peritoneal metastases from colorectal and gastric cancer the PCI score acquires a specific role acting as the cut-off between patients who can undergo curative surgery or palliation. Long-term results show that the only group enjoying favorable results are patients with limited disease (a statistical minority). By applying to appropriately selected patients with primary malignancies a proactive management strategy including HIPEC we can treat patients with microscopic peritoneal dissemination and therefore at PCI 0. Among treated conditions pseudomyxoma peritonei enjoys the best results. But a major future advance comes from identifying among lesions at major risk of pseudomyxoma.

show abstract

“…Cette histoire naturelle n'est plus vraie de nos jours grâce à la chirurgie de cytoréduction associée à la chimiothérapie hyperthermique intrapéritonéale peropé-ratoire (CHIP). Ce traitement relativement récent, quand il est réalisable, est recommandé dans la prise en charge de la carcinose péritonéale d'origine colorectale [2][3][4][5][6].…”

Section: Introductionunclassified

Pièges et faux-semblant de la TEP/TDM au 18F-FDG dans le bilan de carcinose péritonéale d’origine colorectale : une analyse de 37 patients

Audollent

Eveno

Dohan

et al. 2015

Journal de Chirurgie Viscérale

View full text Add to dashboard Cite

Is There a Possibility of a Cure in Patients With Colorectal Peritoneal Carcinomatosis Amenable to Complete Cytoreductive Surgery and Intraperitoneal Chemotherapy?

Abstract: The cure rate (16%) after complete CRS of colorectal peritoneal carcinomatosis, followed by IPC, in selected patients is close to that obtained after resection of colorectal liver metastases.

Cited by 237 publications

References 45 publications

Avoidance of Early Post-Operative Intraperitoneal Chemotherapy (EPIC) Following Peritonectomy with Heated Intraperitoneal Chemotherapy (HIPEC) Significantly Reduces Cost and Hospital Stay

Avoidance of Early Post-Operative Intraperitoneal Chemotherapy (EPIC) Following Peritonectomy with Heated Intraperitoneal Chemotherapy (HIPEC) Significantly Reduces Cost and Hospital Stay

Proactive Management for Gastric, Colorectal and Appendiceal Malignancies: Preventing Peritoneal Metastases with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Pièges et faux-semblant de la TEP/TDM au 18F-FDG dans le bilan de carcinose péritonéale d’origine colorectale : une analyse de 37 patients

Contact Info

Product

Resources

About