Results of Systematic Second-look Surgery Plus HIPEC in Asymptomatic Patients Presenting a High Risk of Developing Colorectal Peritoneal Carcinomatosis

Élias, Dominique; Honoré, Charles; Dumont, Frédéric; Ducreux, Michel; Boige, Valérie; Malka, David; Burtin, Pascal; Dromain, Clarisse; Goèré, Diane

doi:10.1097/sla.0b013e31822638f6

Cited by 212 publications

(140 citation statements)

References 26 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…The role of prophylactic HIPEC in gastric cancer patients without peritoneal metastasis has been demonstrated in numerous studies and meta-analysis (72-74). Elias et al (75) advised surgical exploration in CRC patients at high-risk for PC after 6 months of adjuvant systemic chemotherapy. The proactive risk management proposed by Sugarbaker includes close monitoring and "second look" surgery when required in patients who are at high-risk of local recurrence and PC, such as tumor perforation, T4 tumors, and obstruction.…”

Section: Discussionmentioning

confidence: 99%

Cytoreductive surgery (SRC) for treatment of peritoneal carcinomatosis and hyperthermic ıntraperitoneal chemotherapy (HIPEC): Our initial experience and technical details

Topgül

Çetinkaya

Arslan

et al. 2015

UCD

View full text Add to dashboard Cite

Objective: The aim of this study is to present our initial experience in peritoneal carcinomatosis treatment and the technical details of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the light of current literature. Material and Methods:Data of 27 consecutive patients who were treated with CRS and HIPEC for peritoneal carcinomatosis in Medical Park Samsun Hospital, between November 2012 and September 2014 were retrospectively reviewed. Treatment indication and management were evaluated at the multidisciplinary oncology council. All patients underwent CRS and HIPEC with the aim of complete cytoreduction. Patients with unresectable disease and/or palliative surgery were excluded from analysis. Perioperative complications were classified according to Clavien-Dindo classification, and HIPEC-related side effects were identified using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) criteria. Demographic, clinical and histopathological data of the patients were analyzed. Results:The mean age was 54 (32-72). Nineteen patients were female. The origin of peritoneal carcinomatosis was colorectal cancer in 12 patients, ovarian cancer in 12 patients, gastric cancer in 2 patients and pseudomyxoma peritonei in 1 patient. The mean Peritoneal Carcinomatosis Index was 12 (3-32), with a mean operative time of 420 (300-660) minutes. Perioperative morbidity, HIPEC-related toxicity and perioperative mortality were observed in eight (30%), one (3.7%) and four patients (14.8%), respectively. During a mean follow up of 13 (1-22) months, overall and disease-free survival rates were 95.8% and 82.6%, respectively. Two patients with colorectal cancer (after 9 and 12 months) and one patient with ovarian cancer (after 11 months) had intra-abdominal recurrence. One patient with ovarian cancer had liver metastases 13 months after surgery, and underwent resection of segments 6-7. The remaining patients are being followed-up without any recurrence. Conclusion:Cytoreductive surgery and HIPEC have favorable results in the treatment of patients with peritoneal carcinomatosis. Compatible with the literature, surgical outcomes of the presented series are encouraging for this treatment modality that have been recently popularized in our country. Careful perioperative evaluation, proper patient selection and multidisciplinary approach are essential for success in curative treatment of peritoneal carcinomatosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Cytoreductive surgery (SRC) for treatment of peritoneal carcinomatosis and hyperthermic ıntraperitoneal chemotherapy (HIPEC): Our initial experience and technical details

Topgül

Çetinkaya

Arslan

et al. 2015

UCD

View full text Add to dashboard Cite

show abstract

“…[15] au prezentat în 2011 rezultatele unui studiu referitor la incidenţa şi tratamentul CP după chirurgia electivă la persoanele apreciate cu risc pentru dezvoltarea CP. Pe un lot de 41 de pacienţi operaţi pentru CCR pe care autorii iau considerat de risc pentru dezvoltarea CP (CP limitată complet rezecată, tumori Krukenberg rezecate odată cu tumora de colon şi tumori perforate în timpul disecției) şi la care examenul CT şi markerii tumorali erau în limite normale neridicând suspiciunea de boală recidivată, practică relaparotomie la aproximativ 1 an.…”

Section: Tratamentul Cp Prin Chirurgie De Citoreducţie şI Chimioterapunclassified

Hyperthermic Intraperitoneal Chemotherapy With Cytoreductive Surgery for the Treatment of Peritoneal Carcinomatosis From Colorectal Orgin

Huțanu¹,

Radu²,

Filip³

et al. 2013

View full text Add to dashboard Cite

Abstract): Peritoneal carcinomatosis due to gastrointestinal malignancies has been considered a poor prognosis entity. Few prospective studies have shown 6 to 12 months suvirval period for peritoneal carcinomatosis of colorectal cancer (CR) treated with systemic chemotherapy. New chemotherapeutic agents and monoclonal antibodies increased survival to 16-22 months. Despite this new systemic treatment most patients will die due to cachexia, peritonitis and/or intestinal occlusion. Normothermic or hyperthermic intraperitoneal chemotherapy, intraoperative or early postoperative became in the last three decades the standard treatment for several malignancies of peritoneum and it has proven effective in peritoneal carcinomatosis of colorectal and ovarian origin. The main drawbacks of this method is lack of studies to confirm the benefits. A long learning curve, high morbidity and mortality, lack of studies on quality of life and the high cost of this procedure appears to be the most important disadvantages of this method. Recent studies including carreful selected patients show a five year suvirval rate of 40%, median survirval period of 30 months, high morbidity (up to 60%) and a mortality up to 8%. Phase III trials on patients with peritoneal carcinomatosis from colorectal cancer treated with HlPEC are still ongoing. We present and review the latest results from the literature regarding the value of HIPEC in peritoneal carcinomatosis from colorectal origin.

show abstract

“…What we now need are data from well-designed randomized control trials addressing two fundamental issues: which patients these trials should include and the optimal timing for HIPEC. Published studies so far focus their efforts in preventing peritoneal metastases in colorectal cancer on second-look surgery plus HIPEC, a strategy proposed by Elias et al [78]. Based on these preliminary results, a multicenter randomized trial was designed in France in 2010 (Prophylochip) [71] comparing, in asymptomatic patients at high risk of colorectal peritoneal metastases, systematic second-look + HIPEC (oxaliplatin intraperitoneally + intravenous 5-FU) with standard surveillance.…”

Section: Proactive Management Of Peritoneal Metastases From Colorectamentioning

confidence: 99%

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

Results of Systematic Second-look Surgery Plus HIPEC in Asymptomatic Patients Presenting a High Risk of Developing Colorectal Peritoneal Carcinomatosis

Cited by 212 publications

References 26 publications

Cytoreductive surgery (SRC) for treatment of peritoneal carcinomatosis and hyperthermic ıntraperitoneal chemotherapy (HIPEC): Our initial experience and technical details

Cytoreductive surgery (SRC) for treatment of peritoneal carcinomatosis and hyperthermic ıntraperitoneal chemotherapy (HIPEC): Our initial experience and technical details

Hyperthermic Intraperitoneal Chemotherapy With Cytoreductive Surgery for the Treatment of Peritoneal Carcinomatosis From Colorectal Orgin

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

Contact Info

Product

Resources

About