Treatment of peritoneal carcinomatosis from colorectal cancer by cytoreductive surgery and hyperthermic perioperative intraperitoneal chemotherapy

Kecmanović, Dragutin; Pavlov, Maja; Ceranic, Miljan; Sepetkovski, A; Kovacevic, P.A.; Stamenković, Aleksandar

doi:10.1016/j.ejso.2004.09.021

Cited by 55 publications

(31 citation statements)

References 17 publications

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“…Some reports suggest that postoperative complications, including anastomotic leakage, bowel perforation, renal dysfunction, respiratory failure, and other complications occurred more frequently when IPHC was applied [35,36,37,38,39], while others claim IPHC is safe [7, 8, 10, 12, 13, 30,40,41,42]. In our modality, there were no surgery or IPHC-related deaths, and renal dysfunction seemed to be the only meaningful complication.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Intraoperative Peritoneal Hyperthermic Chemotherapy for Advanced Gastric Cancer Patients with Serosal Invasion

Zhu¹,

Tang²,

Yan³

et al. 2006

Dig Surg

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Aims: This study was undertaken to investigate the clinical effects and safety of intraoperative peritoneal hyperthermic chemotherapy (IPHC) for advanced gastric cancer (AGC) patients. Methods: A total of 118 AGC patients with serosal invasion were enrolled in this study from 1998 to 2001, 52 underwent IPHC after gastrectomy and 66 were treated with gastrectomy only. Among these cases, 96 patients without macroscopic peritoneal metastases were selected for the prophylactic study, 22 with peritoneal metastases were selected for the therapeutic study. Postoperative survival, recurrence pattern and incidences of postoperative complications between patients with and without IPHC were analyzed and compared. Results: For the prophylactic study, the IPHC procedure improves postoperative survival rate and decrease the incidence of peritoneal recurrence, and is an independent prognostic factor for these patients. For the therapeutic study, postoperative survival times were longer if IPHC was undertaken. No surgery-related death occurred. The incidence of renal dysfunction was higher in the IPHC group, but all patients recovered without hemodialysis. Conclusion: IPHC is a safe procedure that improves the survival prognosis for AGC patients with serosal invasion. It is especially beneficial for patients without peritoneal metastasis due to the reduction of postoperative peritoneal recurrence.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Intraoperative Peritoneal Hyperthermic Chemotherapy for Advanced Gastric Cancer Patients with Serosal Invasion

Zhu¹,

Tang²,

Yan³

et al. 2006

Dig Surg

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“…In fact, such strategy has proven beneficial for patients with peritoneal carcinomatosis resulting from colon cancer, and held promise for treatment of patients with mesothelioma and other gastrointestinal malignancies 4–13. As a result, in some centers, cytoreductive surgery and CHPP has become standard treatment for patients with mesothelioma and peritoneal carcinomatosis associated with gastrointestinal and ovarian malignancies 5,14–17. Recently, these promising results have led to the publication of a consensus statement strongly suggesting that cytoreductive surgery and CHPP become standard treatment for patients with colon cancer and peritoneal carcinomatosis without distant metastasis 18…”

mentioning

confidence: 99%

Cytoreductive Surgery and Continuous Hyperthermic Peritoneal Perfusion in Patients with Mesothelioma and Peritoneal Carcinomatosis: Hemodynamic, Metabolic, and Anesthetic Considerations

et al. 2008

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Cytoreductive surgery and continuous hyperthermic peritoneal perfusion (CHPP) involve the conduct of a complex surgical procedure and delivery of high-dose hyperthermic chemotherapy to the peritoneum. This therapeutic modality has been shown to benefit patients with peritoneal carcinomatosis resulting from gastrointestinal and ovarian tumors and mesothelioma. However, it is unknown whether the primary disease (mesothelioma versus peritoneal carcinomatosis) affects hemodynamic and metabolic perturbations during the course of CHPP with cisplatin. We examined the perioperative course of patients undergoing CHPP with cisplatin and evaluated the effect of primary diagnosis (mesothelioma versus peritoneal carcinomatosis) on hemodynamic and metabolic parameters in response to peritoneal perfusion. Sixty-nine mesothelioma and 100 peritoneal carcinomatosis patients underwent 169 consecutive cytoreduction and CHPP procedures with general anesthesia. During CHPP, patients from both groups developed significant increases in central venous pressure, and heart rate, decreases in mean arterial pressure (all P < 0.0001), metabolic acidosis with significant decreases in pH and bicarbonate (P < 0.0001), deterioration of gas exchange with significant increases in PaCO 2 and oxygen alveolar-arterial gradient (P < 0.0001), and significant increases in activated partial thromboplastin time (aPTT) and prothrombin time (PT) and decreases in hematocrit and platelet counts (all P < 0.0001). However, patients with mesothelioma had lesser increases in temperature (P < 0.01) and heart rate (P < 0.0001) and lesser decreases in hematocrit (P = 0.0013) during CHPP and greater decreases in sodium bicarbonate (P = 0.0082) after completion of CHPP compared with patients with peritoneal carcinomatosis. We conclude that the transient hemodynamic and metabolic perturbations associated with cytoreductive surgery and CHPP with cisplatin can vary according to the primary diagnosis (mesothelioma versus peritoneal carcinomatosis) warranting this therapy.Z. M. N. Quezado, MD, e-mail: zquezado@nih.gov. NIH Public Access Author ManuscriptAnn Surg Oncol. Author manuscript; available in PMC 2009 February 9. Published in final edited form as:Ann Surg Oncol. 2009 February ; 16(2): 334-344. doi:10.1245/s10434-008-0253-z. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptMesothelioma and peritoneal carcinomatosis resulting from gastrointestinal and gynecological malignancies are associated with decreased quality of life, significant morbidity, and poor survival with currently available systemic chemotherapies. 1,2 Often in patients with mesothelioma and peritoneal carcinomatosis the peritoneal surface is the only site of disease progression, and distant metastases are absent. For these reasons, regional treatment of mesothelioma and peritoneal carcinomatosis resulting from various primary malignancies may offer significant advantages over systemic therapy. 1 In order to treat patients with peritoneal carcinomatosis and mesothelioma,...

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“…After the surgical cytoreduction, the size of residual disease was usually expressed as R1, meaning no macroscopic residual disease, R2a, meaning macroscopic residual disease less than 2.5 or 5 mm, or R2b, meaning macroscopic residual disease more than 2.5 or 5 mm in diameter. When reported, median survival following complete R1 resection of all macroscopic disease varied from 17.8 months to 39.0 months, 52,54,57,60,65,66 whereas the reported 5-year survival rates varied from 20% to 54%. 49,52,57,66 Median survival after incomplete R2a resection resulted in median survival times of 12.5 months to 24 months, 36,52,54,57,60,66 with 5-year survival rates of between 10% and 29%.…”

Section: Prognostic Indicators Of Survivalmentioning

confidence: 80%

“…Furthermore, in 7 trials patients with hematogenous metastases were eligible for inclusion. 48,50,51,57,58,65,66 IPEC was administered intraoperatively in 6 trials, 36 55 Two trials, finally, used 5-FU alone, 49,54 whereas in one trial oxaliplatin was administered. 51 The clinical outcomes with respect to long-term survival varied considerably.…”

Section: Cytoreductive Surgery and (Hyperthermic) Ipec In Pc Of Colormentioning

confidence: 99%

Peritoneal Carcinomatosis of Colorectal Origin

Koppe

Boerman²,

Oyen³

et al. 2006

Annals of Surgery

452

138

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Treatment of peritoneal carcinomatosis from colorectal cancer by cytoreductive surgery and hyperthermic perioperative intraperitoneal chemotherapy

Cited by 55 publications

References 17 publications

Efficacy and Safety of Intraoperative Peritoneal Hyperthermic Chemotherapy for Advanced Gastric Cancer Patients with Serosal Invasion

Efficacy and Safety of Intraoperative Peritoneal Hyperthermic Chemotherapy for Advanced Gastric Cancer Patients with Serosal Invasion

Cytoreductive Surgery and Continuous Hyperthermic Peritoneal Perfusion in Patients with Mesothelioma and Peritoneal Carcinomatosis: Hemodynamic, Metabolic, and Anesthetic Considerations

Peritoneal Carcinomatosis of Colorectal Origin

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