Learning curve of combined modality treatment in peritoneal surface disease

Smeenk, R.M.; Verwaal, Victor J.; Zoetmulder, F.A.N.

doi:10.1002/bjs.5863

Cited by 205 publications

(150 citation statements)

References 31 publications

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“…Over the years, reduction of post-operative mortality has been reported from tertiary centres worldwide. Moran reported a decreased mortality rate from 18 % down to 3 % [11,30], The Netherlands Cancer Institute reported a decrease in mortality from 8 % to 4 % [9], and Yan et al reported a decrease from 7 % to 1 % [10], all of which point towards the strong influence of the learning curve.…”

Section: Importance Of Blearning Curvetmentioning

confidence: 99%

“…Several studies showed that pulmonary complications can be reduced by local experience, better peri-operative fluid and glycemic control and multi-disciplinary management of patients undergoing CRS and HIPEC [9,[30][31][32].…”

Section: Pulmonary Complicationsmentioning

confidence: 99%

“…The authors [9,10] concluded that the improvement in the perioperative outcome of patients over time was the result of improved surgical techniques, increased experience and other intuitive factors that are difficult to quantify. Over the years, reduction of post-operative mortality has been reported from tertiary centres worldwide.…”

Section: Importance Of Blearning Curvetmentioning

confidence: 99%

“…In a systematic review of literature, Chua et al reported that morbidity and mortality associated with CRS and HIPEC performed in specialized centers were not significantly superior compared to morbidity and mortality of other major gastrointestinal interventions [2]. Several authors have reported reduction of morbidity and mortality over time, stressing the importance of the Blearning curve^principle [9][10][11]. In this article, we review the complications that can occur after CRS and HIPEC and the risk factors associated with increased incidence of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 96%

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Complications of Cytoreductive Surgery and HIPEC in the Treatment of Peritoneal Metastases

Mehta

Gelli

Agarwal

et al. 2016

Indian J Surg Oncol

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The combined treatment concept of cytoreductive surgery (CRS) and Hyperthermic intraperitoneal chemotherapy (HIPEC) has shown to be an efficient therapeutic option for selected patients with primary and secondary peritoneal carcinomatosis (PC). This strategy represents the standard of care for diseases like pseudomyxoma peritonei and peritoneal mesothelioma, and offers the best long-term results for PC from colorectal cancer. Despite these results, skepticism exists regarding this therapeutic approach partly because of its perceived high toxicity. In this article, we review the current evidence on complications that can occur after CRS and HIPEC and the risk factors associated with increased incidence of morbidity and mortality.

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Section: Importance Of Blearning Curvetmentioning

confidence: 99%

Section: Pulmonary Complicationsmentioning

confidence: 99%

Section: Importance Of Blearning Curvetmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Complications of Cytoreductive Surgery and HIPEC in the Treatment of Peritoneal Metastases

Mehta

Gelli

Agarwal

et al. 2016

Indian J Surg Oncol

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“…HIPEC has a well demonstrated learning curve. [72] Over the years, the morbidity and mortality of this procedure has declined and is comparable to that of CRS alone. Table 4 lists that morbidity and mortality rates reported in various studies with HIPEC for ovarian cancer.…”

Section: Morbidity and Mortality Of Crs And Hipec In Ovarian Cancermentioning

confidence: 99%

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Bhatt

Gléhen

2016

Indian J Surg Oncol

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Ovarian cancer is one of the leading causes of cancer related deaths in women worldwide. It is usually diagnosed in an advanced stage (Stages III and IV) when peritoneal cancer spread has already occurred. The standard treatment comprises of surgery to remove all macroscopic disease followed by systemic chemotherapy. Despite all efforts, it recurs in over 75 % of the cases, most of these recurrences being confined to the peritoneal cavity. Recurrent ovarian cancer has a poor long term outcome and is generally treated with multiple lines of systemic chemotherapy and targeted therapy. The propensity of ovarian cancer to remain confined to the peritoneal cavity warrants an aggressive locoregional approach. The combined treatment comprising of cytoreductive surgery (CRS) that removes all macroscopic disease and HIPEC (Hyperthermic Intraperitoneal Chemotherapy) has been effective in providing long term survival in selected patients with peritoneal metastases of gastrointestinal origin. Intraperitoneal chemotherapy used as adjuvant therapy has shown a survival benefit in ovarian cancer. This has prompted the use of CRS and HIPEC in the management of ovarian cancer as a part of first line therapy and second line therapy for recurrent disease. This article reviews the current literature and evidence for the use of HIPEC in ovarian cancer.

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Initial Experience With Hyperthermic Intraperitoneal Chemotherapy

Turrini

Lambaudie²,

Viret³

et al. 2012

Arch Surg

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Background: Until 2004, we treated peritoneal carcinomatosis with cytoreductive surgery accompanied by perioperative systemic chemotherapy. From October 2004, we decided to initiate a hyperthermic intraperitoneal chemotherapy (HIPEC) program for this condition. Objective: To determine the effect of HIPEC on postoperative outcomes at a single institution performing a high volume of cancer operations. Method: Sixty consecutive patients underwent cytoreductive surgery plus HIPEC (oxaliplatin; 460 mg/m 2 in 2 L/m 2) from October 1, 2004, through December 31, 2010. Usual perioperative factors were studied for 3 groups of patients who underwent HIPEC: 0 to 20 HIPEC procedures (period 1), 21 to 40 HIPEC procedures (period 2), and 41 to 60 HIPEC procedures (period 3). Results: The mean peritoneal carcinomatosis index was 9.6, the mean duration of surgery was 410.7 minutes, and the mean blood loss was 450.2 mL/L. Mortality and mor

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Learning curve of combined modality treatment in peritoneal surface disease

Abstract: The learning curve of combined modality treatment for peritoneal surface disease is long, and reflects patient selection and treatment expertise.

Cited by 205 publications

References 31 publications

Complications of Cytoreductive Surgery and HIPEC in the Treatment of Peritoneal Metastases

Complications of Cytoreductive Surgery and HIPEC in the Treatment of Peritoneal Metastases

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Initial Experience With Hyperthermic Intraperitoneal Chemotherapy

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