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heated intraperitoneal chemotherapy

Marco Lotti, Michela Giulii Capponi, Luca Campanati, Elia Poiasina, Luca Ansaloni, Eugenio Poletti, Luigi Frigerio
INTRODUCTION: Hyperthermic intraperitoneal chemotherapy (HIPEC) is delivered after cytoreductive surgery (CRS) in selected patients with peritoneal carcinomatosis. The closed-abdomen technique, preferred by many centers, prevents heat loss and drug spillage, but does not warrant homogeneous distribution of the perfusion fluid (PF). The hypothesized formation of intra-abdominal adhesions during the closed-abdomen perfusion period has never been described. MATERIALS AND METHODS: From March 2014 to April 2016, 10 consecutive patients with peritoneal carcinomatosis, selected for CRS, underwent the Laparoscopy-Enhanced HIPEC technique to explore the abdominal cavity during the perfusion...
October 5, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chukwuemeka Ihemelandu, Michael N Mavros, Paul Sugarbaker
BACKGROUND: Appendiceal cancer most commonly metastasizes to the peritoneum. Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) is the standard of care for appendiceal cancer with peritoneal metastases. Adverse events postoperatively have been associated with reduced survival. We analyzed clinical outcomes, including complications after CRS and HIPEC in patients with appendiceal cancer, in a recent cohort of patients to identify prognostic factors. METHODS: Patients undergoing CRS with HIPEC for appendix cancer with peritoneal metastases between January 2007 and December 2009 were identified...
June 23, 2016: Annals of Surgical Oncology
David Badrudin, Camille Perrault-Mercier, Antoine Bouchard-Fortier, Julien Hubert, François A Leblond, Lucas Sideris, Pierre Dubé
BACKGROUND: Pemetrexed is a systemic chemotherapeutic agent used in the treatment of malignant mesothelioma. This drug represents a potentially promising intraperitoneal (IP) agent to use for hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal mesothelioma. However, this has yet to be supported by preclinical studies. Therefore, we aimed to study the effect of pemetrexed dose and perfusion temperature on the resultant pemetrexed concentration in 3 different compartments (systemic circulation, portal circulation and peritoneal tissues) using a murine model...
May 20, 2016: Surgical Oncology
S Gouy, G Ferron, O Glehen, A Bayar, F Marchal, C Pomel, F Quenet, J M Bereder, M C Le Deley, P Morice
PURPOSE: Hyperthermic intraperitoneal chemotherapy (HIPEC) may improve the outcome of patients with initially unresectable ovarian cancer who are eligible for complete cytoreductive surgery (CCRS) after neoadjuvant chemotherapy. The main objective of this multicenter phase-I study was to identify the recommended dose of cisplatin for HIPEC at CCRS after neoadjuvant carboplatin and paclitaxel (CP). METHODS: Patients were treated with 6cycles of CP followed by CCRS and HIPEC using cisplatin heated for one hour at 42°C+/-1°C...
August 2016: Gynecologic Oncology
Adrian Cravioto-Villanueva, Magdalena Cavazos, Pedro Luna-Perez, Hector Martinez-Gomez, María Lourdes Ramirez, Juan Solorzano, Hermelindo Montiel, Jesus Esquivel
BACKGROUND AND PURPOSE: The long-term survival of patients with peritoneal carcinomatosis of colorectal origin has been achieved with cytoreductive surgery, which removes all macroscopic implants, combined with hyperthermic intraperitoneal chemotherapy (HIPEC). The current technology for administering intraperitoneal heated chemotherapy is expensive and, for some institutions, unaffordable. We conducted this study to assess the temperature stability provided by a modified, inexpensive system, to offer a simple and low cost alternative to the standard HIPEC delivery equipment...
August 2016: Surgery Today
Jean-Sébastien Trépanier, Lucas Sidéris, Lawrence Lee, Jean-François Tremblay, Pierre Drolet, Pierre Dubé
BACKGROUND: Electrocautery (EC) is used during cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Using a murine model, we studied the effect of HIPEC on small bowel EC lesions and surrounding normal tissues. METHODS: Thirty-two rats were divided into five groups: a control group with EC lesions; EC plus intraperitoneal heated 5% dextrose (D5W); EC plus oxaliplatin (OXA, 460 mg/m(2)); EC plus mitomycin C 10 mg/m(2) (MMC10); EC plus MMC 35 mg/m(2) (MMC35)...
August 2016: International Journal of Hyperthermia
A V Padmakumar
Hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with cytoreductive surgery is a targeted treatment approach in which tumors that have spread through the lining of the abdomen are removed and then heated chemotherapy is perfused throughout the abdomen, with the intent of killing any remaining cancer cells that may be present after all the visible disease has been removed surgically. The chemotherapy is administered in high dosages to the targeted area and washed out, thereby limiting the systemic toxicity...
June 2016: Indian Journal of Surgical Oncology
Rangole Ashvin, Jain Nikhilesh
Peritoneal dissemination is a significant variable affecting long term survival of abdominal cancer patients. A generally accepted clinical point of view is that peritoneal dissemination is tantamount to distant organ metastases. This implies it to be a terminal condition. Current practice dictates that if peritoneal dissemination is observed intraoperatively, the curative therapeutic options are deferred and comprehensive systemic chemotherapy remains the only option with a dismal prognosis. The past few years have generated lot of interest in management of peritoneal carcinomatosis...
June 2016: Indian Journal of Surgical Oncology
Andrew D Newton, Edmund K Bartlett, Giorgos C Karakousis
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with prolonged survival for appropriately selected patients with peritoneal dissemination of abdominal malignancies. CRS and HIPEC has been criticized for perceived high rates of morbidity and mortality. Morbidity and mortality rates of CRS and HIPEC, however, do not appear dissimilar to those of other large abdominal surgeries, particularly when relevant patient and operative factors are accounted for. The risk of morbidity and mortality following this surgery for a given individual can be predicted in part by a variety of patient and operative factors...
February 2016: Journal of Gastrointestinal Oncology
Paul L Feingold, Mei Li M Kwong, Arvind Sabesan, Rebecca Sorber, Udo Rudloff
Gastric cancer is the fourth most commonly diagnosed cancer worldwide, and once spread to the peritoneum, has a 5-year survival of less than 5%. Recent years have demonstrated advances in the use of cytoreductive surgery (CRS) in combination with heated intraperitoneal chemotherapy (HIPEC) for the treatment of peritoneal carcinomatosis due to various malignancies. The frequent desmoplastic stroma and poor vascularization impeding drug delivery particularly in the diffuse form of gastric cancer is thought to provide a sound rationale for a regionalized treatment approach in this disease...
February 2016: Journal of Gastrointestinal Oncology
Russell N Low
MR imaging provides considerable advantages for imaging patients with peritoneal tumor. Its inherently superior contrast resolution compared to CT allows MRI to more accurately depict small peritoneal tumors that are often missed on other imaging tests. Combining different contrast mechanisms including diffusion-weighted (DW) MRI and gadolinium-enhanced MRI provides a powerful tool for preoperative and surveillance imaging in patients being considered for cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC)...
February 2016: Journal of Gastrointestinal Oncology
Marco Lotti, Michela Giulii Capponi, Dario Piazzalunga, Elia Poiasina, Michele Pisano, Roberto Manfredi, Luca Ansaloni
Hyperthermic intraperitoneal chemotherapy (HIPEC) is currently delivered after cytoreductive surgery in patients with several kinds of peritoneal surface malignancies. Different methods for delivering HIPEC have been proposed all of them being variations between two modalities: the open technique and the closed technique. The open technique assures optimal distribution of heat and cytotoxic solution, with the disadvantage of heat loss and leakage of cytotoxic drugs. The closed technique prevents heat loss and drug spillage, increases drug penetration, but does not warrant homogeneous distribution of the perfusion fluid...
January 2016: Journal of Minimal Access Surgery
Alexander Hotouras, David Desai, Chetan Bhan, Jamie Murphy, Björn Lampe, Paul H Sugarbaker
BACKGROUND: Despite advances in surgical oncology, most patients with primary ovarian cancer develop a recurrence that is associated with a poor prognosis. The aim of this review was to establish the impact of Heated IntraPEritoneal Chemotherapy (HIPEC) in the overall survival of patients with recurrent ovarian cancer. METHODS: A search of PubMed/MEDLINE databases was performed in February 2015 using the terms "recurrent ovarian cancer," "cytoreductive surgery/cytoreduction," and "heated/hyperthermic intraperitoneal chemotherapy...
May 2016: International Journal of Gynecological Cancer
Murali R Kuracha, Peter Thomas, Brian W Loggie, Venkatesh Govindarajan
Pseudomyxoma peritonei (PMP) is a neoplastic syndrome characterized by peritoneal tumor implants with copious mucinous ascites. The standard of care for PMP patients is aggressive cytoreductive surgery performed in conjunction with heated intraperitoneal chemotherapy. Not all patients are candidates for these procedures and a majority of the patients will have recurrent disease. In addition to secreted mucin, inflammation and fibrosis are central to PMP pathogenesis but the molecular processes that regulate tumor-stromal interactions within the peritoneal tumor microenvironment remain largely unknown...
April 2016: Cancer Medicine
Vladimir G Bespalov, Galina S Kireeva, Olesya A Belyaeva, Oleksiy E Kalinin, Konstantin Y Senchik, Alexandr N Stukov, Georgy I Gafton, Konstantin D Guseynov, Alexey M Belyaev
BACKGROUND AND OBJECTIVES: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at the time of Cytoreductive Surgery (CRS) is an actively researched treatment in patients with advanced ovarian cancer. Relative contribution of heat and chemotherapeutic agents during HIPEC as well as efficacy of a new agent dioxadet for regional chemotherapy in a rat model of ovarian cancer was studied. METHODS: Sixty rats were divided into three groups: no treatment control group (n = 19), hyperthermia without chemotherapy (HIPEP) (n = 14), HIPEC + cisplatin (n = 14), HIPEC + dioxadet (n = 13)...
March 2016: Journal of Surgical Oncology
Harveshp D Mogal, Edward A Levine, Nora F Fino, Chukwuemeka Obiora, Perry Shen, John H Stewart, Konstantinos I Votanopoulos
BACKGROUND: Routine postoperative intensive care unit (ICU) observation of patients undergoing cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) is driven by historically reported morbidity and mortality data. The validity of this practice and the criteria for ICU admission have not been elucidated. METHODS: A prospectively maintained database of 1146 CRS/HIPEC procedures performed from December 1991 to 2014 was retrospectively analyzed...
May 2016: Annals of Surgical Oncology
Stéphanie Lapointe, Fouad Zhim, Lucas Sidéris, Pierre Drolet, Syndie Célestin-Noël, Pierre Dubé
BACKGROUND: The quality of tissue repairs depends on tissue integrity, surgical technique, and material properties of the sutures used. Currently, there is no clear consensus on which is the best suture to use during cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. The aim of this study was to evaluate the impact of heat and chemotherapy on sutures' biomechanical properties. METHODS: Six different 3.0 absorbable sutures (Biosyn, Dexon II, Maxon, Monocryl, PDS II, and Vicryl Plus) were tested...
January 2016: Journal of Surgical Research
Hai Lin, Bong Ha Heo, Myung Ha Yoon
BACKGROUND: Chemotherapy-induced peripheral neuropathy is a major side effect of anti-cancer drugs, and our knowledge of its mechanisms is lacking. Several models for chemotherapy-induced neuropathy have been introduced. However, the outcomes of these models differ significantly among laboratories. Our object was to create a model of chemotherapy-induced neuropathy in rats with cancer. METHODS: Female Sprague-Dawley rats were used. Mammary rat metastasis tumor (MRMT-1) cells were implanted subcutaneously in rats...
October 2015: Korean Journal of Pain
Sean P Dineen, Kristen A Robinson, Christina L Roland, Karen A Beaty, Safia Rafeeq, Paul F Mansfield, Richard E Royal, Keith F Fournier
BACKGROUND: Patients with colorectal cancer and peritoneal carcinomatosis (CRC/PC) may benefit from cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC). Nutritional support is frequently required for patients after CRS/HIPEC. It remains unclear if placement of feeding access is of benefit in regard to improving postoperative nutrition in this patient population. MATERIALS AND METHODS: Patients with CRC/PC who underwent complete cytoreduction were evaluated...
January 2016: Journal of Surgical Research
Harveshp D Mogal, Edward A Levine, Greg Russell, Perry Shen, John H Stewart, Konstantinos I Votanopoulos
INTRODUCTION: Survival of patients after cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy for appendiceal neoplasms is projected by conventional overall survival (OS) curves that do not address the survival time a patient has already accrued. We sought to study the conditional survival (CS) after CRS, contingent on patients surviving a fixed duration of time after surgery. METHODS: A retrospective analysis of 493 appendiceal cancer patients from a prospective database was performed...
February 2016: Annals of Surgical Oncology
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