Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer

Sugarbaker, Paul H.; Cunliffe, W. J.; Belliveau, James F.; Bruijn, E. A. de; Graves, Theresa A.; Mullins, Richard E.; Schlag, Peter M.

doi:10.1007/978-2-8178-0782-9_67

Cited by 150 publications

(148 citation statements)

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“…This technique was further popularized by Dr Paul Sugarbaker [58]. The main principle of surgery is the complete removal of all macroscopic or visible disease.…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Chia

Seshadri

Képénékian³

et al. 2016

Pleura and Peritoneum

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Background: The current treatment of choice for peritoneal carcinomatosis from gastric cancer is systemic chemotherapy. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a new aggressive form of loco-regional treatment that is currently being used in pseudomyxoma peritoneii, peritoneal mesothelioma and peritoneal carcinomatosis from colorectal cancer. It is still under investigation for its use in gastric cancer. Methods: The literature between 1970 and 2016 was surveyed systematically through a review of published studies on the treatment outcomes of CRS and HIPEC for peritoneal carcinomatosis from gastric cancer. Results: Seventeen studies were included in this review. The median survival for all patients ranged from 6.6 to 15.8 months. The 5-years overall survival ranged from 6 to 31%. For patients with complete cytoreduction, the median survival was 11.2 to 43.4 months and the 5-years overall survival was 13 % to 23%. Important prognostic factors were found to be a low peritoneal carcarcinomatosis index (PCI) score and the completeness of cytoreduction.

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“…This technique was further popularized by Dr Paul Sugarbaker [58]. The main principle of surgery is the complete removal of all macroscopic or visible disease.…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Chia

Seshadri

Képénékian³

et al. 2016

Pleura and Peritoneum

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“…Peritoneal surface malignancy if treated by surgery alone, inevitably progresses because of free intraperitoneal tumor emboli, fibrin entrapment of intraabdominal tumor emboli on denuded peritoneal surfaces and progression of entrapped tumor cells through growth factors involved in wound healing process [13]. Perioperative chemotherapy given by intraperitoneal route reduces the chances of progression of disease by killing the residual microscopic disease.…”

Section: Discussionmentioning

confidence: 99%

Application of Advanced Multimodality Care to Pseudomyxoma Peritonei Patient: Report of First Patient Treated at a Tertiary Center

Khan

Suhaibani

Mohaimed

et al. 2010

Indian J Surg Oncol

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Pseudomyxoma peritonei following dissemination of appendicealmucinous neoplasms is slowly progressive but inevitably a lethal condition. It is locally invasive and does not lead to lymph node or distant metastasis making it amenable for more radical procedures. We present a case of pseudomyxoma peritonei treated by Cytoreductive surgery(CRS)and heated intraperitoneal chemotherapy(HIPEC) with Mitomycin C (12.5mg/m2 ) at 41.50 C. This was followed by five cycles of early postoperative intraperitoneal chemotherapy (EPIC) with 5FU (650 mg/m2) over 5 days. Patient underwent standard Peritonectomy procedure combined with resection of gallbladder, Spleen, subtotal colectomy and resection of part of small bowel. Blood loss during theprocedure was 4000ml. Histopathology revealed Pseudomyxoma peritonei (hybrid type). The patient recuperated well and was discharged and now is living a productive life. Peritonectomy with perioperative intraperitoneal chemotherapy is the current standard of treatment for appendiceal tumors with peritoneal dissemination which offers a hope of disease free long survival in such patients.

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“…Intraperitoneal chemotherapy is best delivered either at the time of surgery or immediately following it since the cytotoxic activity of perioperative intraperitoneal chemotherapy destroys the cancer cells within the fibrin produced as part of the wound healing process. Delayed administration of intraperitoneal chemotherapy not only results in poor penetration of the chemotherapeutic agent into the cells trapped in the scar but also in a non-uniform distribution of chemotherapy within the peritoneal cavity due to adhesions [32].…”

Section: Rationale For Hipecmentioning

confidence: 99%

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

Seshadri

Gléhen

2016

Indian J Surg Oncol

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Peritoneal metastasis, either synchronous or metachronous, is commonly seen in gastric cancer. It is associated with a poor prognosis, with a median survival of less than one year. The outcomes are not significantly improved by the use of systemic chemotherapy. We review the relevant literature on the role of HIPEC in gastric cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used in three situations in gastric cancer. Besides its role as a definitive treatment in patients with established peritoneal metastasis (PM), it has been used as a prophylaxis against peritoneal recurrence after curative surgery and also as a palliative treatment in advanced peritoneal metastasis with intractable ascites. While prophylactic HIPEC has been shown to reduce peritoneal recurrence and improve survival in many randomised trials, palliative HIPEC can reduce the need for frequent paracentesis. Although CRS with HIPEC has shown promise in increasing the survival of selected patients with established PM from gastric cancer, larger studies are needed before this can be accepted as a standard of care.

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Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer

Cited by 150 publications

References 0 publications

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Application of Advanced Multimodality Care to Pseudomyxoma Peritonei Patient: Report of First Patient Treated at a Tertiary Center

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

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