The American Society of Peritoneal Surface Malignancies (ASPSM) Multiinstitution Evaluation of the Peritoneal Surface Disease Severity Score (PSDSS) in 1,013 Patients with Colorectal Cancer with Peritoneal Carcinomatosis

Esquivel, Jesús; Lowy, Andrew M.; Markman, Maurie; Chua, Terence C.; Pelz, Joerg; Baratti, Dario; Baumgartner, Joel M.; Berri, Richard N.; Bretcha-Boix, Pedro; Deraco, Marcello; Flores-Ayala, Guillermo; Gléhen, Olivier; Gómez-Portilla, Alberto; González-Moreno, Santiago; Goodman, Martin; Halkia, Evgenia; Kusamura, Shigeki; Möller, Mecker G.; Passot, Guillaume; Pocard, Marc; Salti, George I.; Sardi, Armando; Senthil, Maheswari; Spilioitis, John; Torres-Melero, J; Turaga, Kiran K.; Trout, Richard

doi:10.1245/s10434-014-3798-z

Cited by 147 publications

(111 citation statements)

References 18 publications

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“…In this system, patient's symptoms (weight loss, ascites, abdominal pain, obstruction), radiologic PCI and primary histopathological features of the tumor (tumor grade, lymph node involvement, lymphatic/venous invasion, signet ring cell histology) are given scores, and the disease is classified into four stages (Figure 2). This staging has been shown to be associated with long-term oncologic results of patients with CRC and PMP treated with CRS and HIPEC, and it has been accepted as a reliable method in the selection of the patients that would benefit from treatment (35,36).…”

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

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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.

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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

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“…Most recently, to improve patient selection, various prognostic scoring systems have been introduced to preoperatively evaluate patients for crs and hipec [19][20][21] . The preoperative parameters used in those scoring systems include histopathology, blood tests (especially serum tumour markers), symptoms, and tumour burden (as evaluated by imaging studies).…”

Section: Patient Selectionmentioning

confidence: 99%

“…In colorectal ptc, the corep score-which consists of one histopathologic variable, hemoglobin, white cell count, and four serum tumour markers and their preoperative changes over time-was able to accurately predict open-close surgery in 87% of subjects, complete crs in 81%, and survival of less than12 months in 83% 19 . In a multicentre retrospective study 20 , colorectal cancer patients with ptc who had no or just mild symptoms, limited ptc, and favourable histology (Peritoneal Surface Disease Severity Score i) had a median overall survival (os) of 86 months; those with some combination of severe symptoms, extensive ptc, and worse histology, such as signet-ring cells (Peritoneal Surface Disease Severity Score iii or iv) had a median os of only 28 months. Patients in the intermediate category (Peritoneal Surface Disease Severity Score ii) had a median os of 48 months.…”

Section: Patient Selectionmentioning

confidence: 99%

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

2016

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Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locoregional treatment for selected patients with ptc from gastric, colorectal, and ovarian cancer; with mesothelioma; and with pseudomyxoma peritonei. In the prophylactic setting, hipec can also be used to prevent ptc in high-risk patients, and the first results of the "second-look" approach are promising. Patient selection-in which the risks of perioperative morbidity and mortality, which are analogous to those for any other major gastrointestinal surgery, are assessed-is of utmost importance. Those risks have to be weighed against the anticipated survival benefit, which depends mainly on tumour biology, extent of disease, and probability of achieving complete crs. The present review discusses the principles of crs and hipec, the most significant recent clinical data, and current perspectives concerning the application of this treatment modality in various malignancies. Ongoing trials and future directions are noted. It appears that the combination of crs and hipec is an indispensable tool in the oncologist's armamentarium.

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“…In some studies, the prognostic factors were grou ped into scores. The Peritoneal Surface Disease Severity Score may be used to stratify patients in clinical trials [97] . Different scores used in PM of colorectal origin are: The Peritoneal Surface Disease Severity Score, the Prognostic Score, and the Colorectal Peritoneal Score.…”

Section: Patient Selectionmentioning

confidence: 99%

Multimodality treatment strategies have changed prognosis of peritoneal metastases

Lungoci

Mironiuc

Muntean

et al. 2016

WJGO

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For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with "terminal status/despair". The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists' perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. Core tip: The multimodal treatment of peritoneal metastases (PM), involving cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, has been strenuously achieved over time, but seems to be the best treatment option, for selected cases. This paper addresses data about the multimodal treatment strategy, focused to patient's survival, the key indicator for assessing results, in the case of PM. Also, it were highlighted the treatment key aspects and the controversies, high in the 35 years of treatment implementing. By understanding the philosophy of multimodal treatment, physicians will be able to offer an alternative to the routine systemic chemotherapy.Lungoci C, Mironiuc AI, Muntean V, Oniu T, Leebmann H, Mayr M, Piso P. Multimodality treatment strategies have changed prognosis of peritoneal metastases.

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The American Society of Peritoneal Surface Malignancies (ASPSM) Multiinstitution Evaluation of the Peritoneal Surface Disease Severity Score (PSDSS) in 1,013 Patients with Colorectal Cancer with Peritoneal Carcinomatosis

Cited by 147 publications

References 18 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

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

Multimodality treatment strategies have changed prognosis of peritoneal metastases

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