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Jürgen Weinreich, Florian Struller, Iaroslav Sautkin, Shalva Giuashvili, Marc Reymond, Alfred Königsrainer, Timm C Schott
We performed an in-vitro study testing the chemosensitivity of peritoneal cancer cell lines (SW620, HCT116, MKN45, 23,132/87, OAW42) to various cytostatic drug regimens. A duplex drug, characterized by reversible linking of the antimetabolites 2'-deoxy-5-fluorouridine (5-FdU) and 3'-C-ethynylcytidine (ECyd), was compared to oxaliplatin or to cisplatin plus doxorubicin. The experiments were designed to reflect the conditions of intraperitoneal chemotherapy. CASY® (Cell Analysis System) technology was used to compare the impact of incubation temperature/duration and drug concentration on the viability of the cancer cell lines versus normal human dermal fibroblasts...
July 18, 2018: Investigational New Drugs
Kim Govaerts, K Chandrakumaran, Norman J Carr, Thomas D Cecil, Sanjeev Dayal, Faheez Mohamed, Andrew Thrower, Brendan J Moran
AIM: Pseudomyxoma peritonei (PMP) is an uncommon malignancy, generally originating from a ruptured epithelial tumour of the appendix. Despite successful cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), some patients recur. Currently there are no guidelines on the methods, frequency and intensity of follow-up. METHODS: Between 1994 and 2016, 1070 patients underwent surgery for a perforated epithelial tumour of the appendix, predominantly with PMP...
July 6, 2018: European Journal of Surgical Oncology
Maximiliano Gelli, Janina F L Huguenin, Thierry de Baere, Léonor Benhaim, Antoine Mariani, Valerie Boige, David Malka, Isabelle Sourouille, Michel Ducreux, Dominique Elias, Diane Goéré
INTRODUCTION: Over the last 20 years, complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) dramatically increased the survival of patients with colorectal peritoneal metastases (CRPM). However, despite better knowledge of the disease, around 70% of patients relapse after CRS with HIPEC. This study was designed to analyse the pattern of recurrence and the outcomes of different treatment modalities. METHODS: Patients relapsing after CRS plus HIPEC for CRPM were selected from a prospective database...
July 5, 2018: European Journal of Cancer
A Arjona-Sanchez, J Esquivel, O Glehen, G Passot, K K Turaga, D Labow, S Rufian-Peña, R Morales, K van der Speeten
BACKGROUND: Minimally invasive surgery is playing an increasing role in the treatment of patients with gastrointestinal and gynaecological malignancies as the data show reduced morbidity, faster recovery and similar oncological outcome when compared to open procedures. MATERIALS AND METHODS: The American Society of Peritoneal Surface Malignancies (ASPSM) conducted a retrospective study to analyse peritonectomy procedures and HIPEC done via the laparoscopic route...
July 12, 2018: Surgical Endoscopy
Grace Hwei Ching Tan, Nicholas B Shannon, Claramae Shulyn Chia, Lui Shiong Lee, Khee Chee Soo, Melissa Ching Ching Teo
Objective: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are increasingly being used to treat peritoneal malignancies. Urological resections and reconstruction (URR) are occasionally performed during the surgery. We aim to evaluate the impact of these procedures on peri-operative outcomes of CRS and HIPEC patients. Methods: A retrospective review of a prospectively maintained database of all patients who underwent CRS-HIPEC from April 2001 to February 2016 was performed...
July 2018: Asian Journal of Urology
Fortuné M K Elekonawo, Manon M D van der Meeren, Geert A Simkens, Johannes H W de Wilt, Ignace H de Hingh, Andreas J A Bremers
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is associated with considerable postoperative morbidity, including ileus and infectious complications. Perioperative care is believed to be an important factor for the development and treatment of postoperative morbidity. PATIENTS AND METHODS: Data on case-matched patients from a retrospective database of 2 Dutch HIPEC centres was compared. Patient selection and procedures were identical in both hospitals although perioperative management items differ slightly...
July 6, 2018: Digestive Surgery
Zachary E Stiles, Nathan M Hinkle, Gitonga Munene, Paxton V Dickson, Andrew M Davidoff, Jeremiah L Deneve
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has improved outcomes for selected patients with peritoneal carcinomatosis and often requires ostomy creation. We examined the impact of ostomy creation in a newly established peritoneal malignancy program. A retrospective review was performed of CRS-HIPEC procedures from 2011 to 2016. Those who did and did not receive an ostomy were compared. Fifty-eight patients underwent CRS-HIPEC and an ostomy was created in 25.9 per cent. Median peritoneal cancer index (14 vs 16, P = 0...
June 1, 2018: American Surgeon
Brice Malgras, Etienne Gayat, Olivier Aoun, Réa Lo Dico, Clarisse Eveno, Karine Pautrat, Jean-Baptiste Delhorme, Guillaume Passot, Frédéric Marchal, Olivia Sgarbura, Gwenael Ferron, Diane Goéré, Thierry Andre, Marc Pocard
BACKGROUND: The introduction of cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) improved the prognosis of selected patients with peritoneal mesothelioma (PM). OBJECTIVE: The objective of our study was to evaluate whether different HIPEC agents were associated with different outcomes in patients with PM. METHODS: From the RENAPE database, we selected all patients with histology-proven PM who underwent CRS + HIPEC from 1989 to 2014...
July 5, 2018: Annals of Surgical Oncology
Teresa P Díaz-Montes, Farah El-Sharkawy, Sarah Lynam, Amy Harper, Michelle Sittig, Ryan MacDonald, Vadim Gushchin, Armando Sardi
OBJECTIVE: Uterine sarcomas (USs) are characterized by poor response to systemic chemotherapy and high recurrence rates. This study evaluates whether the use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) confers survival benefit in comparison with conventional treatment modalities in patients with recurrent US. METHODS/MATERIALS: A retrospective analysis of patients with recurrent US at a single institution for an 11-year study period was performed...
July 2018: International Journal of Gynecological Cancer
Yuqing Zhang, Zhiyang Liu, Benjamin D Thackray, Zhouzhou Bao, Xia Yin, Fenglei Shi, Jianbo Wu, Jian Ye, Wen Di
Abdominal miliary spread and metastasis is one of the most aggressive features in advanced ovarian cancer patients. The current standard treatment of advanced ovarian cancer is cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). However, most patients cannot receive optimal CRS outcomes due to the extreme difficulty of completely excising all microtumors during operation. Though HIPEC can improve prognosis, treatment is untargeted and may damage healthy organs and cause complications...
July 4, 2018: Small
Satya Das, Chanjuan Shi, Liping Du, Kamran Idrees, Jordan Berlin
PURPOSE: Adenocarcinoma ex-goblet cell carcinoids (AGCCs) are rare appendiceal tumors with mixed neuroendocrine and glandular features. They tend to behave more aggressively than typical carcinoid tumors, affect younger patients, and have a greater predilection for spreading to the peritoneum. Outcomes of AGCC patients treated with chemotherapy, extrapolated from colon cancer regimens, in the adjuvant or metastatic setting have not been explicitly reported. We sought to explore outcomes of AGCC patients with either local disease treated with adjuvant FOLFOX or metastatic disease treated with FOLFOX/FOLFIRI post-cytoreductive debulking (or CRS plus HIPEC in the peritoneal-limited setting)...
July 4, 2018: Journal of Gastrointestinal Cancer
P Horvath, A Königsrainer
BACKGROUND: The principle of surgical treatment of peritoneal metastases of ovarian cancer in the primary as well as in the recurrent disease setting includes macroscopic complete cytoreductive surgery. The addition of intraperitoneal chemotherapy after cytoreduction is currently not part of the standard treatment. OBJECTIVE: Data on intraperitoneal chemotherapy for treatment of peritoneal metastases of ovarian cancer are presented focusing on overall and progression-free survival and on morbidity and mortality rates...
July 5, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
D Bleiler, S Bleiler, B Sinner
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are therapeutic options for the treatment of intra-abdominal neoplasms. Following the resection of all visible tumor areas by CRS, microscopic tumor areas are treated with HIPEC. This procedure increases the quality of life and survival. The CRS with HIPEC is a complex surgical procedure in which the mainly younger and often otherwise healthy patients undergo several pathophysiological changes during the operation. The main concern of the anesthesiologist is the massive volume loss, volume shift and metabolic alterations...
July 3, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Adrian Bartos, Caius Breazu, Dana Bartos, Lidia Ciobanu, Calin Mitre
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves the prognosis in selected patients with peritoneal surface malignancies but it is an extensive procedure predisposing to major complications. Among them renal toxicity was reported. Severe renal insufficiency is considered a contraindication for this complex procedure. We present a patient with diabetic nephropathy with renal insufficiency KDOQI 3 and peritoneal metastasis from sigmoid adenocarcinoma with a good clinical outcome after CRS with HIPEC, highlighting the anesthetic precautions considered for this particular clinical case...
October 2017: Journal of Critical Care Medicine
Horacio N López-Basave, Osvaldo A Quiroz-Sandoval, Alejandro E Padilla-Rosciano, Alberto M León-Takahashi, Gerardo Miranda-Devora, Araceli Arrollo-Monroy
Patients with peritoneal carcinomatosis (PC) of gastric origin have a poor prognosis of life with an average survival of 1-3 months. Systemic chemotherapy has improved the survival of those patients with gastric metastatic cancer at 7-10 months. However, this benefit could not be reproduced in those patients with PC. The current literature for the use of hyperthermic intraperitoneal chemotherapy (HIPEC) for gastric PC has significant variation related to patient selection, treatment intent (palliative vs. attempt at curative treatment), surgical technique, intraperitoneal chemotherapy agent utilized, and systemic chemotherapy administered adjuvantly...
2018: Cirugia y Cirujanos
Z J Lee, S L Chia, G Tan, K C Soo, C C M Teo
BACKGROUND: Peritoneal carcinomatosis from colorectal cancer is a stage 4 disease for which palliative chemotherapy has traditionally been considered the mainstay of treatment. Since the development of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) by Sugarbaker, this combined method treatment has resulted in improved survival outcomes with acceptable morbidity for selected patients with peritoneal carcinomatosis. This study examined the cost effectiveness of CRS and HIPEC compared with palliative chemotherapy for patients with peritoneal carcinomatosis from colorectal cancer within the context of the Singaporean health care system...
June 8, 2018: Annals of Surgical Oncology
Yinuo Tu, Yunhong Tian, Yinbing Wu, Shuzhong Cui
Heat shock proteins (HSPs) are important factors in the response of cancer cells to thermo- and chemotherapy. Transient hyperthermic intraperitoneal chemoperfusion (HIPEC) therapy results in the upregulation of HSP expression, which may compromise the efficacy of additional anticancer treatments. The aim of the present study was to monitor the kinetics of HSP expression in tumor cells and patients with gastric cancer following HIPEC. Thus, in vitro and in vivo experiments were conducted to investigate the expression of two HSP family members, HSP70 and HSP90...
June 2018: Oncology Letters
Sonata Trumbeckaite, Vaidotas Cesna, Aldona Jasukaitiene, Rasa Baniene, Antanas Gulbinas
Gastrointestinal cancers (gastric, pancreatic and colorectal) are life-threatening diseases, which easily spread to peritoneal cavity (Juhl et al. in Int J Cancer 57:330-335, 1994; Schneider et al. in Gastroenterology 128:1606-1625, 2005; Geer and Brennan in Am J Surg 165:68-72 1993). Application of hyperthermal intraperitoneal chemotherapy (HIPEC) is one of the choices treating these malignancies and prolonging patient survival time. Despite numbers of clinical trials showing positive effects of HIPEC against various types of cancer, the question whether hyperthermia significantly potentiate the cytotoxicity of cisplatin remains unanswered...
June 25, 2018: Journal of Bioenergetics and Biomembranes
Stefano Cianci, Giuseppe Vizzielli, Anna Fagotti, Fabio Pacelli, Andrea Di Giorgio, Alessandro Tropea, Antonio Biondi, Giovanni Scambia
The role of loco-regional treatment of peritoneal carcinomatosis using intraperitoneal chemotherapy is still investigated. Actually, new technologies are suitable for these procedures, especially a new hybrid system using CO2 called Peritoneal Recirculation System (PRS-1.0 Combat). A HIPEC procedure in a porcine model using the PRS system was conducted. The objective of experimentation was to assess the distribution of liquid inside the abdomen, by using methylene blue instead of chemotherapy. Moreover, we positioned six different thermal probes in different abdominal regions inside the abdomen to measure the temperature during procedure...
June 25, 2018: Updates in Surgery
Judith E K R Hentzen, Steven J de Jongh, Patrick H J Hemmer, Willemijn Y van der Plas, Gooitzen M van Dam, Schelto Kruijff
Patients with peritoneal carcinomatosis (PC) from colorectal origin may undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) as a curative approach. One major prognostic factor that affects survival is completeness of cytoreduction. Molecular Fluorescence Guided Surgery (MFGS) is a novel intraoperative imaging technique that may improve tumor identification in the future, potentially preventing over- and under-treatment in these patients. This narrative review outlines a chronological overview of MFGS development in patients with PC of colorectal origin...
June 24, 2018: Journal of Surgical Oncology
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