Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey

Ferron, Gwénaël; Simón, Lucía; Guyon, Frédéric; Gléhen, Olivier; Goèré, Diane; Élias, Dominique; Pocard, Marc; Gladieff, Laurence; Bereder, Jean Marc; Brigand, Cécile; Classe, Jean‐Marc; Guilloit, Jean-Marc; Quénet, François; Abboud, Karine; Arvieux, C.; Bibeau, Frédéric; Chaisemartin, Cécile de; Delroeux, Delphine; Durand-Fontanier, Sylvaine; Goasguen, N.; Gouthi, L.; Heyd, Bruno; Kianmanesh, Réza; Leblanc, Éric; Loi, Valeria; Lorimier, G.; Marchal, Frédéric; Mariani, Pascale; Mariette, C.; Méeus, Pierre; Msika, Simon; Ortega‐Deballon, Pablo; Paineau, J; Pezet, Denis; Piessen, Guillaume; Pirrò, N.; Pomel, Christophe; Porcheron, J.; Pourcher, Guillaume; Rat, Patrick; Régimbeau, Jean‐Marc; Sabbagh, Charles; Thibaudeau, Emilie; Torrent, Juan José; Tougeron, David; Tuech, Jean‐Jacques; Zinzindohoué, Franck; Lundberg, Peter W.; Herin, F.; Villeneuve, Laurent

doi:10.1016/j.ejso.2015.07.012

Cited by 30 publications

(22 citation statements)

References 34 publications

(36 reference statements)

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“…A clinical study remains necessary to validate these findings. Since the environmental risks of the open technique are well recognized, and given the hypothetical risk of higher systemic toxicity with the open technique, the results of the present study tend to support the use of the closed abdomen technique for HIPEC with pemetrexed. However, the conclusion of a resulting disadvantage of the open technique cannot be drawn from this murine study.…”

Section: Discussionsupporting

confidence: 58%

“…The surgical technique and technology used in the setting of HIPEC have greatly evolved in the past few decades . Delivery of HIPEC using the open abdomen technique entails an increased risk of surgical team and environmental exposure to cytotoxic agents with the theoretical advantage of more homogenous distribution of heat and drug over the closed abdomen technique. Nevertheless, there are reports of more stable hemodynamic parameters in closed abdomen HIPEC, as well as techniques to control the homogeneity of heat distribution .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of open and closed abdomen techniques for the delivery of intraperitoneal pemetrexed using a murine model

Badrudin

Sidéris

Perrault-Mercier

et al. 2018

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Comparison of open and closed abdomen techniques for the delivery of intraperitoneal pemetrexed using a murine model

Badrudin

Sidéris

Perrault-Mercier

et al. 2018

Journal of Surgical Oncology

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“…Other studies have been unable to detect cytotoxic therapeutics in the blood or urine of individuals involved in the administration of open HIPEC[ 17 , 18 ]. This would suggest that there is limited risk of contamination with cytotoxic agents if appropriate precautions are taken when dealing with these toxic compounds, although no official guidelines exist as to what these precautions should be[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of open and closed hyperthermic intraperitoneal chemotherapy: Results from the United States hyperthermic intraperitoneal chemotherapy collaborative

Leiting

Cloyd

Ahmed

et al. 2020

WJGO

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BACKGROUND Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis can be performed in two ways: Open or closed abdominal technique. AIM To evaluate the impact of HIPEC method on post-operative and long-term survival outcomes. METHODS Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative database. Post-operative, recurrence, and overall survival outcomes were compared between those who received open vs closed HIPEC. RESULTS Of the 1812 patients undergoing curative-intent CRS and HIPEC, 372 (21%) patients underwent open HIPEC and 1440 (79%) underwent closed HIPEC. There was no difference in re-operation or severe complications between the two groups. Closed HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d mortalities. On multi-variable analysis, closed HIPEC technique was not a significant predictor for overall survival (hazards ratio: 0.75, 95% confidence interval: 0.51-1.10, P = 0.14) or recurrence-free survival (hazards ratio: 1.39, 95% confidence interval: 1.00-1.93, P = 0.05) in the entire cohort. These findings remained consistent in the appendiceal and the colorectal subgroups. CONCLUSION In this multi-institutional analysis, the HIPEC method was not independently associated with relevant post-operative or long-term outcomes. HIPEC technique may be left to the discretion of the operating surgeon.

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“…There is a wide variation in the methodology of HIPEC treatment. A 2015 survey of 34 different French teams found a lack of uniformity in HIPEC technique [24]. Even though many of the participants were from expert institutions and had been involved in training members from the other teams, there were differences with regard to open versus closed techniques, equipment used, protective mechanisms, and training [24].…”

Section: Techniquementioning

confidence: 99%

Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer

Cowan

O’Cearbhaill

Zivanovic

et al. 2017

International Journal of Hyperthermia

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The natural history of advanced-stage epithelial ovarian cancer is one of clinical remission after surgery and platinum/taxane-based intravenous and/or intraperitoneal chemotherapy followed by early or late recurrence in the majority of patients. Prevention of progression and recurrence remains a major hurdle in the management of ovarian cancer. Recently, many investigators have evaluated the use of normothermic and hyperthermic intraoperative intraperitoneal drug delivery as a management strategy. This is a narrative review of the current status of clinical trials of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in ovarian cancer and the future directions for this treatment strategy. The existing studies on HIPEC in patients with epithelial ovarian cancer are mostly retrospective in nature, are heterogeneous with regards to combined inclusion of primary and recurrent disease, and lack unbiased data. Until data are available from evidence-based trials, it is reasonable to conclude that surgical cytoreduction and HIPEC is a rational and interesting, though still investigative, approach in the management of epithelial ovarian cancer, whose use should be employed within prospective clinical trials.

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Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey

Cited by 30 publications

References 34 publications

Comparison of open and closed abdomen techniques for the delivery of intraperitoneal pemetrexed using a murine model

Comparison of open and closed abdomen techniques for the delivery of intraperitoneal pemetrexed using a murine model

Comparison of open and closed hyperthermic intraperitoneal chemotherapy: Results from the United States hyperthermic intraperitoneal chemotherapy collaborative

Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer

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