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hyperthermic intraperitoneal chemotherapy

H Leebmann, P Piso
Peritoneal carcinomatosis remains a therapeutic challenge. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is currently the only potentially curative option with good results. For good oncological results a complete macroscopic cytoreduction is essential. This mostly requires a complex operative procedure with significant morbidity and mortality. Therefore, multimodal treatment is limited to a few highly selected patients. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new minimally invasive approach, the value and spectrum of applications of which are still under investigation; however, the articles on PIPAC published so far are encouraging and PIPAC is therefore a possible palliative therapy option for patients who are not eligible for CRS and HIPEC...
June 21, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Renata D'Alpino Peixoto, Tercia Tarciane de Sousa, Pedro Alexandre Ismael Amaral Silva, Luciana Rodrigues de Meirelles, Carlos Henrique Andrade Teixeira
Background: Peritoneal carcinomatosis is usually a terminal disease with short median survival in patients with gastric cancer. Systemic FOLFOX is one of the most used regimens in the first-line treatment of metastatic gastric cancer. However, there is scarce evidence that cytoreductive surgery (CRS) and intraperitoneal heated chemotherapy (HIPEC) improves oncological outcomes of patients with advanced gastric cancer. Methods: Herein we present a case of a young woman with advanced gastric cancer with omental and peritoneal metastases who achieved an excellent response after 6 months of FOLFOX followed by CRS and HIPEC...
May 2018: Case Reports in Oncology
Sven Van Poucke, Dana Huskens, Kurt Van der Speeten, Mark Roest, Bart Lauwereins, Ming-Hua Zheng, Seppe Dehaene, Joris Penders, Abraham Marcus, Marcus Lancé
BACKGROUND AND OBJECTIVES: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal peroperative chemotherapy (HIPEC), indicated for patients with peritoneal metastases from digestive or gynecological malignancies alike, demonstrates a considerable impact on hemostatic metabolism, both on platelet and on coagulation level. The potential hemostatic interference in CRS and HIPEC is phase dependent. The hypothesis of this prospective cohort study is that the procedure exposed an increased thrombotic risk, resulting in a faster and increased thrombin generation and hyper platelet function...
2018: PloS One
George I Salti, Samer A Naffouje
BACKGROUND: In light of the modern surgical trend towards minimally invasive surgery, we aim to assess the feasibility of hand-assisted laparoscopic (HAL) cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal surface malignancy (PSM). METHODS: Patients with PSM secondary to colorectal cancer or pseudomyxoma peritonei with peritoneal cancer index (PCI) of ≤ 10 were considered for HAL CRS and HIPEC. One patient had PCI of 15 but based on the disease distribution laparoscopic-assisted CRS and HIPEC was thought to be feasible, thus was also included...
June 20, 2018: Surgical Endoscopy
Erica S Tsang, Yarrow J McConnell, David F Schaeffer, Lawrence Lee, Yaling Yin, Siham Zerhouni, Kimberly Schaff, Caroline Speers, Hagen F Kennecke
BACKGROUND: Goblet cell carcinoids (GCCs) of the appendix are rare mucinous neoplasms, for which optimal therapy is poorly described. We examined prognostic clinical and treatment factors in a population-based cohort. METHODS: Patients diagnosed with GCC from 1984 to 2014 were identified from the British Columbia Cancer Agency and the Vancouver Lower Mainland Pathology Archive. RESULTS: Of 88 cases with confirmed appendiceal GCCs, clinical data were available in 86 cases (annual population incidence: 0...
June 18, 2018: Annals of Surgical Oncology
Bharat Panuganti, Ea-Sle Chang, Cyril W Helm, Theresa Schwartz, Eddy C Hsueh, Jinhua Piao, Jinping Lai, Jula Veerapong
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are combined to treat peritoneal surface malignancies (PSM). The objective of cytoreduction is to eradicate macroscopic disease, while HIPEC addresses residual microscopic disease. Currently, there are no protocols guiding treatment of cirrhotic patients with PSM. We report the case of a cirrhotic patient with signet ring cell (SRC) appendiceal adenocarcinoma who underwent normothermic, as opposed to hyperthermic intraperitoneal chemotherapy (IPC)...
June 2018: Gastroenterology Research
Fabian Grass, David Martin, Michael Montemurro, Patrice Mathevet, Anita Wolfer, George Coukos, Nicolas Demartines, Martin Hübner
AIMS OF THE STUDY: The present survey aimed to evaluate current opinion and practice regarding peritoneal metastasis (PM), satisfaction with available treatment options, and need for new therapeutic approaches. METHODS: This was a qualitative study conducted between October 2016 and October 2017 in the Réseau Suisse Romand d'Oncologie including 101 members of various oncological specialties. Participants' demographics, current practice, knowledge, and satisfaction regarding available treatment options and need for new treatment options were assessed by semantic differential scales through 33 closed questions with automatic reminders at 4-, 8-, 12-, and 16-week intervals...
June 13, 2018: Chemotherapy
Audrius Dulskas, Tomas Poskus, Eligijus Poskus, Kestutis Strupas
Background: Appendiceal mucinous tumour (AMT) is a very uncommon disease. We aimed to evaluate preoperative and postoperative characteristics as well as long-term outcomes of patients with appendiceal mucinous adenomas and peritoneal pseudomyxoma (PMP). Methods: A consecutive cohort of patients diagnosed with AMT were included in the study. Tumour recurrence and the development of PMP was diagnosed based on the patients' complaints, physical examination, imaging studies, and biopsy results...
April 2018: Visceral Medicine
Sanket Mehta, Lilian Schwarz, John Spiliotis, Mao-Chih Hsieh, Eduardo H Akaishi, Diane Goere, Paul H Sugarbaker, Dario Baratti, François Quenet, David L Bartlett, Laurent Villeneuve, Vahan Kepenekian
INTRODUCTION: Peritoneal metastasis (PM) of hepatocellular carcinoma (HCC) without distant spread are rare. The related prognosis is poor without standard treatment available. The role of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is poorly documented. METHODS: An international multicentric cohort was constituted by retrospective analysis of 21 patients undergoing CRS/HIPEC for PM of HCC between 1992 and 2016 from 10 reference centers of PSOGI...
May 28, 2018: European Journal of Surgical Oncology
Paul H Sugarbaker
PURPOSE OF REVIEW: Peritoneal metastases may occur from a majority of cancers that occur within the abdomen or pelvis. When cancer spread to the peritoneal surfaces is documented, a decision regarding palliation vs. an aggressive approach using cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy must be made. The perioperative chemotherapy may be hyperthermic intraperitoneal chemotherapy (HIPEC) administered in the operating room or early postoperative intraperitoneal chemotherapy (EPIC) administered in the first 4 or 5 postoperative days...
June 8, 2018: Current Oncology Reports
Armando Sardi, Carlos A Muñoz-Zuluaga, Michelle Sittig, Teresa Diaz-Montes
Peritoneal sarcomatosis from uterine sarcoma is a rare disease with no effective treatment and poor prognosis. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has successful results in peritoneal carcinomatosis from gastrointestinal/gynecological origins. We show that CRS/HIPEC is safe, feasible, and may benefit selected patients with peritoneal sarcomatosis from uterine sarcoma.
June 2018: Clinical Case Reports
Vivek Subbiah, Salah-Eddine Lamhamedi-Cherradi, Branko Cuglievan, Brian A Menegaz, Pamela Camacho, Winston W Huh, Vandhana Ramamoorthy, Peter M Anderson, Raphael E Pollock, Dina Lev, Wei Qiao, Mary Frances McAleer, Robert S Benjamin, Shreyaskumar Patel, Cynthia E Herzog, Najat C Daw, Barry W Feig, Alexander J Lazar, Andrea Hayes-Jordan, Joseph A Ludwig
Purpose Desmoplastic small round cell tumor (DSRCT), which harbors EWSR1-WT1 t(11;22)(p13:q12) chromosomal translocation, is an aggressive malignancy that typically presents as intra-abdominal sarcomatosis in young males. Given its rarity, optimal treatment has not been defined. Experimental Design We conducted a retrospective study of 187 DSRCT patients treated at MD Anderson Cancer Center over two decades. Univariate and multivariate regression analyses were performed. We determined whether chemotherapy, complete cytoreductive surgery (CCS), hyperthermic intraperitoneal cisplatin (HIPEC), and/or whole abdominal radiation (WART) improve overall survival in DSRCT patients...
June 5, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Paul Ametsbichler, Antje Böhlandt, Dennis Nowak, Rudolf Schierl
INTRODUCTION: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a new promising treatment for patients with peritoneal carcinomatosis. It is supposed to provide a higher local drug concentration and deeper penetrate into the tumor tissue compared to systemic chemotherapy or hyperthermic intraperitoneal chemotherapy perfusion (HIPEC). Due to the application of cytotoxic drug aerosols within the operating room (OR), concern has been raised regarding the occupational exposure risk of the involved OR staff...
May 22, 2018: European Journal of Surgical Oncology
Grace Hwei Ching Tan, Claramae Shulyn Chia, Sze Huey Tan, Khee Chee Soo, Melissa Ching Ching Teo
BACKGROUND: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are used in the management of selected peritoneal malignancies. While most patients achieve long-term disease-free survival, there remains a group with early recurrence (ER). We aim to investigate the clinical factors associated with ER. METHODS: A retrospective review of a prospectively maintained database of CRS-HIPEC patients treated between April 2001 and Feb 2016 was performed...
June 5, 2018: International Journal of Clinical Oncology
Lindsey Winer, Francisco I Macedo, Abdullah Alfawaz, Antonio Sommariva, Giovanni Cecchetto, Holly L Neville, Mecker G Möller
The management of pediatric abdominopelvic angiosarcoma remains unclear due to limited clinical experience. Herein, we presented the first 2 pediatric patients with abdominal angiosarcoma who were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) after neoadjuvant therapy. The first patient is alive with recurrent disease at 1-year follow-up and the second patient remains disease free after 1 year. CRS and HIPEC should be considered as a therapeutic option in the management of pediatric abdominal angiosarcomas...
May 31, 2018: Journal of Pediatric Hematology/oncology
Joji Kitayama, Hironori Ishigami, Hironori Yamaguchi, Yasunaru Sakuma, Hisanaga Horie, Yoshinori Hosoya, Alan Kawarai Lefor, Naohiro Sata
Despite recent advances in chemotherapy, outcomes of patients with peritoneal metastases (PM) from gastric cancer are still very poor and standard treatment has not been established. Although oral S-1 appears to be effective for patients with PM, the effects of systemic chemotherapy are limited. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) yield fewer benefits in patients with PM from gastric cancer than in patients with PM from other malignancies. In comparison, repeated intraperitoneal chemotherapy (RIPEC) with taxanes using an implantable peritoneal access port has a pharmacokinetic advantage for the control of peritoneal lesions and in combination with systemic chemotherapy can result in surprisingly long-term survival in patients with PM from gastric cancer...
March 2018: Annals of gastroenterological surgery
S Ndaw, O Hanser, V Kenepekian, M Vidal, M Melczer, A Remy, A Robert, N Bakrin
BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) has been introduced over the last decade for the treatment of peritoneal carcinomatosis. In this procedure, heated cytotoxic drugs are administered directly into the abdominal cavity, ensuring cancer cells to be exposed while reducing systemic toxicity. More recently, pressurized intraperitoneal aerosol chemotherapy (PIPAC), where the chemotherapeutic drug is injected into the peritoneal cavity as an aerosol under pressure, has been proposed to patients in palliative situation, as a new approach...
May 28, 2018: Toxicology Letters
Evgenia Halkia, George Chrelias, Charalambos Chrelias, Jesus Esquivel
Ovarian cancer peritoneal carcinomatosis requires a multimodal-treatment approach. Current treatment considerations are analyzed in this update and include the management of recurrent malignant ascites and the understanding of its pathophysiology, the role of peritoneal washing cytology in detecting peritoneal metastases, capsular invasion and ovarian cancer histologic type, interpretation of pretreatment Ca-125 levels at different time points of ovarian cancer therapeutic management, characteristics of 10-year survivors of high-grade ovarian cancer, and the role of lymphadenectomy in ovarian cancer peritoneal carcinomatosis...
2018: Gastroenterology Research and Practice
Raquel Bravo, Mehnareh D Jafari, Alessio Pigazzi
BACKGROUND: To assess the role of diagnostic laparoscopy (DL) to evaluate candidates for optimal cytoreduction surgery of peritoneal carcinomatosis (PC) combined with hyperthermic intraperitoneal chemotherapy in a consecutive series. METHODS: The characteristics of 31 patients undergoing DL between August 2012 and October 2016 for a diagnosis of PC secondary to digestive neoplasms were retrospectively reviewed. RESULTS: Laparoscopic evaluation was successful and well-tolerated in 100% patients (N=31)...
May 18, 2018: American Journal of Clinical Oncology
Xinhua Chen, Jun Luo, Hao Liu, Yuehong Chen, Yanfeng Hu, Tuanjie Li, Tian Lin, Yu Zhu, Mingli Zhao, Hao Chen, Guoxin Li, Jiang Yu
Advanced gastric cancer (AGC) has a high recurrence rate (especially peritoneal relapse) and a poor prognosis. Systematic chemotherapy or targeted therapy have not been able to significantly reduce the major cause of an unfavorable prognosis, namely the high peritoneal AGC recurrence rate post-surgery. Further studies concerning the application of hyperthermic intraperitoneal chemotherapy (HIPEC) post curative surgery for AGC patients, namely the prophylactic HIPEC (P-HIPEC), have involved a prophylactic approach to prevent peritoneal relapse following curative gastrectomy in high-risk patients...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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