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Cohen L, Alam F, Flood MP, Mohan H, Jain A, Guerra G, Heriot AG, Kong JCH. A systematic review of minimally invasive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal malignancy. ANZ J Surg 2024; 94:1324-1332. [PMID: 38747542 DOI: 10.1111/ans.19021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is traditionally a maximally invasive operation with a large abdominal incision and multi-visceral resections. However, to minimize abdominal wall morbidity and improve functional recovery, some centres have adopted a minimally invasive (MI) approach in select cases. The primary aim of this systematic review and meta-analysis was to assess the evidence for safety and patient selection for minimally invasive approaches to CRS and HIPEC with curative intent. METHODS A PRISMA-compliant systematic review was performed using three electronic databases: Ovid MEDLINE, EMBASE and Web of Science. Data regarding postoperative morbidity was meta-analysed. RESULTS Thirteen studies met the inclusion criteria (N = 462 MI patients), all of which were retrospective in design. Six studies included an open comparison group. Pseudomyxoma peritonei, mesothelioma and ovarian carcinoma made up the majority of cases (>90%), with a PCI < 10 listed as a prerequisite to selection across all studies. On pooled analysis there was no difference in major morbidity between MI and open groups (OR 0.52 95% CI 0.18-1.46, P = 0.33). There was one perioperative death reported in the MI group. Length of stay appeared shorter in the MI group (median range MI: 4-11 v Open: 7-13 days). Short-term recurrence and overall survival between both groups also appeared no different. CONCLUSION Minimally invasive CRS and HIPEC appears feasible and safe in appropriately selected patients. Clear histological stratification and longer term follow up is required to determine oncological safety, particularly in more aggressive tumours such as colorectal peritoneal metastases.
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Affiliation(s)
- Lauren Cohen
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Faizah Alam
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael P Flood
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Mohan
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Anshini Jain
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Glen Guerra
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Alexander G Heriot
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Joseph C H Kong
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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Pawar A, Warikoo V, Salunke A, Sharma M, Pandya S, Bhardwaj A, KS S, Aaron J. Outcomes of minimal access cytoreductive surgery (M-CRS) and HIPEC/EPIC vs. open cytoreductive surgery (O-CRS) and HIPEC/EPIC in patients with peritoneal surface malignancies: a meta-analysis. Pleura Peritoneum 2024; 9:1-13. [PMID: 38558870 PMCID: PMC10980983 DOI: 10.1515/pp-2023-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/15/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Minimal Access Surgery (MAS) has shown better peri-operative outcomes with equivalent oncological outcomes in gastrointestinal and thoracic oncology. Open CRS (O-CRS) procedure accompanies inevitable and significant surgical morbidity in patients. The aim of the review article is to compare outcomes of M-CRS and HIPEC/EPIC with open procedure in peritoneal surface malignancies. Content Comprehensive search of databases was done and total 2,807 articles were found (2793-PubMed and 14-Cochrane review). PRISMA flow chart was prepared and 14 articles were selected. Meta-analysis was performed according to PRISMA guidelines using random-effects model (DerSimonian Laird) and fixed effect model. Publication bias was tested with Funnel plot and Egger's regression test. Quality of studies was assessed by Newcastle-Ottawa scale. Summary and Outlook Patients in both groups [total (732), M-CRS(319), O-CRS(413)] were similar in demographic characteristics. Peri-operative outcomes were significantly better in M-CRS group in terms of blood loss SMD=-2.379, p<0.001 (95 % CI -2.952 to -1.805), blood transfusion RR=0.598, p=0.011 (95 % CI 0.402 to 0.889), bowel recovery SMD=-0.843, p=0.01 (95 % CI -1.487 to -0.2), hospital stay SMD=-2.348, p<0.001 (95 % CI -3.178 to -1.519) and total morbidity RR=0.538, p<0.001 (95 % CI 0.395 to 0.731). Duration of surgery SMD=-0.0643 (95 % CI -0.993 to 0.865, p=0.892) and CC0 score RR=1.064 (95 % CI 0.992 to 1.140, p=0.083) had no significant difference. Limited studies which evaluated survival showed similar outcomes. This meta-analysis shows that M-CRS and HIPEC/EPIC is feasible and has better peri-operative outcomes compared to open procedure in patients with limited peritoneal carcinoma index (PCI) peritoneal surface malignancies. Survival outcomes were not calculated. Further studies are warranted in this regard.
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Affiliation(s)
- Ajinkya Pawar
- Department of Surgical Oncology, GCRI, Ahmedabad, India
| | - Vikas Warikoo
- Department of Surgical Oncology, GCRI, Ahmedabad, India
| | | | - Mohit Sharma
- Department of Surgical Oncology, GCRI, Ahmedabad, India
| | | | - Amol Bhardwaj
- Department of Surgical Oncology, GCRI, Ahmedabad, India
| | - Sandeep KS
- Department of Surgical Oncology, GCRI, Ahmedabad, India
| | - Jebin Aaron
- Department of Surgical Oncology, GCRI, Ahmedabad, India
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3
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Arjona-Sanchez A, Aziz O, Passot G, Salti G, Serrano A, Esquivel J, Van der Speeten K, Sommariva A, Kazi M, Shariff U, Martínez-Regueira F, Piso P, Yonemura Y, Turaga K, Sgarbura O, Avanish Saklani A, Tonello M, Rodriguez-Ortiz L, Vazquez-Borrego MC, Romero-Ruiz A, Glehen O. Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Long term oncologic outcomes from the international PSOGI registry. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:107001. [PMID: 37579618 DOI: 10.1016/j.ejso.2023.107001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/07/2023] [Accepted: 07/29/2023] [Indexed: 08/16/2023]
Abstract
The laparoscopic approach for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (L-CRS + HIPEC) in highly selected patients was previously reported from the PSOGI registry with a demonstrable reduction in length of stay and post-operative morbidity. This study aims to update this international PSOGI registry with a larger cohort of patients and a longer follow-up period. METHODS An international registry was designed through a networking database (REDCAP®). All centers performing L-CRS + HIPEC were invited through PSOGI to submit data on their cases. Variables such as demographics, clinical outcomes, and survival were analyzed. RESULTS A total of 315 L-CRS + HIPEC cases were provided by 14 worldwide centers. A total of 215 patients were included in the L-CRS + HIPEC group. The median peritoneal cancer index (PCI) was 3 (3-5). The median length of stay was 7 days (5-10) and the major morbidity (Clavien-Dindo ≥3) was 6.1% after 30 days. The 5-year disease-free survival (DFS) per tumor origin was: 94% for PMP-LG, 85% for PMP-HG, 100% for benign multicyst peritoneal mesothelioma (MPM), 37.4% for colonic origin, and 54%(at 3 years) for ovarian origin. The 5 years overall survival (OS) per tumor origin was: 100% for PMP-LG, PMP-HG and MPM; 61% for colonic origin, and 74% (at 3 years) for ovarian origin. In addition, a total of 85 patients were analyzed in the laparoscopic risk-reducing HIPEC (L-RR + HIPEC). The median length of stay was 5 days (4-6) and the major morbidity was 6% after 30 days. The 5-year DFS per tumor origin was: 96% for perforated low grade appendiceal mucinous neoplasm (LAMN II) and 68.1% for colon origin. The 5 years OS per tumor origin was: 98% for LAMN II and 83.5% for colonic origin. CONCLUSIONS Minimally invasive CRS + HIPEC is a safe procedure for selected patients with peritoneal carcinomatosis in specialized centers. It improves perioperative results while providing satisfactory oncologic outcomes. L-RR + HIPEC represents a promising strategy that could be evaluated in patients with high risk of developing peritoneal carcinomatosis into prospective randomized trials.
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Affiliation(s)
- A Arjona-Sanchez
- Unit of Surgical Oncology, Reina Sofia University Hospital, Cordoba, Spain; GE09 Research in Peritoneal and Retroperitoneal Oncologic Surgery Group. Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, Department of Biochemistry and Molecular Biology, University of Cordoba, Córdoba, Spain.
| | - O Aziz
- Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, UK
| | - G Passot
- Department of Surgical Oncology, Hospices Civils de Lyon, Lyon, France
| | - G Salti
- Department of Surgical Oncology, Edward-Elmhurst Health, Naperville, IL, USA; The University of Illinois, Chicago, USA
| | - A Serrano
- Unit of Surgical Oncology, University Hospital Fuenlabrada, Madrid, Spain
| | | | | | - A Sommariva
- Advanced Surgical Oncology Unit, Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - M Kazi
- Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai. Homi Bhabha National Institute, Mumbai. Advanced Centre for Treatment, Research, And Education in Cancer, India
| | - U Shariff
- University Hospitals Birmingham NHS Foundation Trust and Birmingham Peritoneal Malignancy Unit, Good Hope Hospital, Birmingham, UK
| | | | - P Piso
- Department for General and Visceral Surgery, Krankenhaus Barmherzige Brueder Regensburg, Germany
| | | | - K Turaga
- Department of Surgery, Yale University School of Medicine, USA
| | - O Sgarbura
- Unit of Surgical Oncology, Institut Du Cancer Montpellier, France
| | - A Avanish Saklani
- Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai. Homi Bhabha National Institute, Mumbai. Advanced Centre for Treatment, Research, And Education in Cancer, India
| | - M Tonello
- Advanced Surgical Oncology Unit, Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - L Rodriguez-Ortiz
- Unit of Surgical Oncology, Reina Sofia University Hospital, Cordoba, Spain; GE09 Research in Peritoneal and Retroperitoneal Oncologic Surgery Group. Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, Department of Biochemistry and Molecular Biology, University of Cordoba, Córdoba, Spain
| | - M C Vazquez-Borrego
- Unit of Surgical Oncology, Reina Sofia University Hospital, Cordoba, Spain; GE09 Research in Peritoneal and Retroperitoneal Oncologic Surgery Group. Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, Department of Biochemistry and Molecular Biology, University of Cordoba, Córdoba, Spain
| | - A Romero-Ruiz
- Unit of Surgical Oncology, Reina Sofia University Hospital, Cordoba, Spain; GE09 Research in Peritoneal and Retroperitoneal Oncologic Surgery Group. Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, Department of Biochemistry and Molecular Biology, University of Cordoba, Córdoba, Spain
| | - O Glehen
- Department of Surgical Oncology, Hospices Civils de Lyon, Lyon, France
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Wahba R, Schmidt T, Buchner D, Wagner T, Bruns CJ. [Surgical treatment of pseudomyxoma peritonei-Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:840-844. [PMID: 37578542 DOI: 10.1007/s00104-023-01937-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Pseudomyxoma peritonei syndrome (PMP) is an orphan disease. Surgery is the fundament of treatment. METHOD Short review summarizing the state of the art treatment. RESULTS Cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) form the foundations of treatment for PMP. The peritoneal cancer index should be preoperatively determined based on imaging and/or laparoscopy, intraoperatively validated and both should be documented. An extraperitoneal surgical preparation technique leads to effective en bloc resection of the peritoneum and the affected abdominal area. The HIPEC technique should be performed with mitomycin C for 60-90 min. Complete CRS (CC = 0, CC = 1) and the histological subtype are relevant for the prognosis. Structured educational programs and mentoring can optimize the learning curve. The aftercare should be performed at the surgical center. After follow-up imaging at 3 months after CRS, in the first 2 years a control should be carried out every 6 months. Thereafter, the intervals can be extended to 1 year. CONCLUSION Standardized surgical treatment and HIPEC, optimized specific surgical training and structured follow-up at the center lead to an excellent long-term prognosis for patients with PMP.
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Affiliation(s)
- Roger Wahba
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
| | - Thomas Schmidt
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| | - Denise Buchner
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| | - Tristan Wagner
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| | - Christiane J Bruns
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
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5
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Le Linn Y, Seo CJ, Wong JSM, Ong CAJ, Chia CS. An Asian Tertiary Centre's Early Experience with Laparoscopic Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis. Indian J Surg Oncol 2023; 14:175-180. [PMID: 37359940 PMCID: PMC10284765 DOI: 10.1007/s13193-022-01632-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/23/2022] [Indexed: 10/14/2022] Open
Abstract
The use of open cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has shown improved oncological survival in terms of treating peritoneal surface malignancies (PSM). However, this procedure often comes with associated morbidity. The move towards use of laparoscopic surgery in this field is postulated to lead to a reduction in morbidity and earlier return to function, but literature on its use for CRS and HIPEC has been scarce. We performed a retrospective review of 6 patients with PSM who underwent laparoscopic CRS and HIPEC in our institution and analysed the patient characteristics, oncological history, perioperative and postoperative outcomes. Median peritoneal cancer index (PCI) score was 0 (IQR 0-1.25). All 6 patients had appendiceal primaries. Median operative time was 285 min (IQR 228.8-300); median length of stay was 7.5 days (IQR 5-8.8). All patients achieved complete cytoreduction, and there was no conversion to open surgery. One patient developed port site infection and another 2 patients subsequently developed adhesions. Median follow-up time was 35 (IQR 17.5-41) months. No patients had developed recurrence at the time of data collection. We conclude that in patients with limited PCI sore (< 2), laparoscopic CRS and HIPEC are safe and feasible. With increasing experience, a select group of patients with limited PSM may be treated via minimally invasive surgery, minimising the morbidity of a traditional laparotomy.
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Affiliation(s)
- Yun Le Linn
- Division of Surgery and Surgical Oncology, Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Chin Jin Seo
- Division of Surgery and Surgical Oncology, Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Jolene Si Min Wong
- Division of Surgery and Surgical Oncology, Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Chin-Ann Johnny Ong
- Division of Surgery and Surgical Oncology, Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
- Duke-NUS Medical School, SingHealth Duke-NUS Oncology Academic Clinical Program, Singapore, Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR Research Entities, Singapore, Singapore
| | - Claramae Shulyn Chia
- Division of Surgery and Surgical Oncology, Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
- Duke-NUS Medical School, SingHealth Duke-NUS Oncology Academic Clinical Program, Singapore, Singapore
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Durán-Martínez M, Gómez-Dueñas G, Rodriguez-Ortíz L, Sanchez-Hidalgo JM, Suárez AG, Casado-Adam Á, Rufián-Peña S, Andujar BR, Valenzuela-Molina F, Vázquez-Borrego MC, Romero-Ruiz A, Briceño-Delgado J, Arjona-Sánchez Á. Learning curve for minimal invasive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) procedures. Langenbecks Arch Surg 2023; 408:146. [PMID: 37046100 DOI: 10.1007/s00423-023-02882-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE The benefits of the minimally invasive approach for performing cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (L-CRS + HIPEC) have been described previously, associating an early recovery with similar oncologic outcomes in patients with limited peritoneal carcinomatosis. Currently, no studies are focusing on the learning curve for this emerging procedure. This study aimed to evaluate the L-CRS + HIPEC learning curve and its knock-on effect on the perioperative outcomes. METHODS We identified all consecutive unselected patients who underwent L-CRS + HIPEC by a single surgeon between April 2016 and January 2022 (n = 51). Patients who underwent risk-reducing CRS + HIPEC (PCI = 0) or initial conversion due to an intraoperative PCI > 10 were excluded from the final analysis. To evaluate the learning curve, perioperative data were analysed using the cumulative sum (CUSUM) analysis. RESULTS Twenty-six patients were included in the final analysis. Major morbidity occurred in one patient (3.8%). The difficulty of the L-CRS + HIPEC procedures was categorised as low in 23.1% (n = 6), intermediate in 19.2% (n = 5), and advanced in 57.7% (n = 15). The mean length of hospital stay was 5.4 ± 1.5 days. No patient had a conversion to open surgery. The learning curve was divided into two distinct phases: the learning phase (1-14) and the consolidation phase (15-26). A significant decrease in the operative time (375 ± 103.1 vs 239.2 ± 63.6 min) was observed with no differences in complexity, the number of peritonectomy procedures, or morbidity. CONCLUSION L-CRS + HIPEC is a complex procedure that must be performed in a high-volume and experienced oncologic unit, requiring a learning curve to achieve the consolidation condition, which could be established after 14 procedures.
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Affiliation(s)
| | | | - Lidia Rodriguez-Ortíz
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Juan Manuel Sanchez-Hidalgo
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Antonio Gordon Suárez
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Ángela Casado-Adam
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Sebastián Rufián-Peña
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Blanca Rufián Andujar
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Francisca Valenzuela-Molina
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - María Carmen Vázquez-Borrego
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | - Antonio Romero-Ruiz
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain
| | | | - Álvaro Arjona-Sánchez
- Unit of Surgical Oncology, University Hospital Reina Sofia, Cordoba, Spain.
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Menendez Pidal Av 14004, Cordova, Spain.
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7
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Gupta V, Rao TS, Raju KVVN, Iyer RR, Ahmed SM, Shah M, Nagaraju R. Outcomes of Laparoscopic Optimal Interval Cytoreduction Surgery (LOICS) in Patients with Advanced Ovarian Cancers Having Low Burden Disease. Indian J Surg Oncol 2023; 14:270-276. [PMID: 36891449 PMCID: PMC9986363 DOI: 10.1007/s13193-022-01682-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/06/2022] [Indexed: 11/19/2022] Open
Abstract
Laparoscopy has been increasingly utilised for cytoreduction surgery in patients with early ovarian cancers. The present study tries to assess the feasibility of laparoscopic interval cytoreduction surgery (LOICS) in patients with advanced ovarian cancer (AOC) having low burden residual disease. A retrospective study of was done of AOC's who underwent LOICS between 2010 and 2014. Epithelial ovarian cancer patients who underwent interval cytoreduction surgery were included and analysed for short-term and long-term outcomes. In all, 36 patients with stage III ovarian cancers were included in the analysis. Twenty-two (61.1%) were grade 3 and 14 (38.8%) were grade 2, and no patient had grade 1 tumour. Stage wise majority were stage IIIC (94.4%) followed by 2 (5.5%) in stage IIIA. There was 1 postoperative complication (2.5%) and no intraoperative complications. Median time to discharge and to start chemotherapy was 5 days and 23 days respectively. After a median follow-up of 60 months, 3 patients (8.3%) were lost to follow-up and the remaining 33 patients were analysed for survival outcomes. The overall survival (OS) and recurrence-free survival (RFS) were 58.3% and 36.1% respectively. The median RFS and OS were 24 months and 51 months, respectively. Most recurrences involved the peritoneum (82.6%), and 5 patients (21.7%) had nodal recurrence alone. Laparoscopic optimal interval cytoreduction is feasible in patients with advanced ovarian cancers provided the disease burden permits optimal surgery, especially in centres with expertise in complex laparoscopic procedures.
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Affiliation(s)
- Vikas Gupta
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Banjara Hills, Rd No 10, Hyderabad, 500034 India
| | - TSubramanyeshwar Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Banjara Hills, Rd No 10, Hyderabad, 500034 India
| | - KVVN Raju
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Banjara Hills, Rd No 10, Hyderabad, 500034 India
| | - R. Rajagopalan Iyer
- Division of Gynecologic Oncology, Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Banjara Hills, Rd No 10, Hyderabad, 500034 India
| | - Syed Murtaza Ahmed
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Banjara Hills, Rd No 10, Hyderabad, 500034 India
| | - Manan Shah
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Banjara Hills, Rd No 10, Hyderabad, 500034 India
| | - Ramchandra Nagaraju
- Department of Surgical Oncology, American Institute of Oncology, Hyderabad, India
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8
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Sommariva A, Valle M, Gelmini R, Tonello M, Carboni F, De Manzoni G, Sorrentino L, Pasqual EM, Bacchetti S, Sassaroli C, Di Giorgio A, Framarini M, Marrelli D, Casella F, Federici O. Laparoscopic Cytoreduction Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Peritoneal Surface Malignancies (PSM): Italian PSM Oncoteam Evidence and Literature Review. Cancers (Basel) 2022; 15:cancers15010279. [PMID: 36612274 PMCID: PMC9818987 DOI: 10.3390/cancers15010279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained increasing acceptance in clinical practice. Performing CRS and HIPEC laparoscopically represents a challenging and intriguing technical evolution. However, the experiences are limited, and the evidence is low. This retrospective analysis was performed on patients treated with laparoscopic CRS-HIPEC within the Italian Peritoneal Surface Malignancies Oncoteam. Clinical, perioperative, and follow-up data were extracted and collected on prospectively maintained databases. We added a systematic review according to the PRISMA method for English-language articles through April 2022 using the keywords laparoscopic, hyperthermic, HIPEC, and chemotherapy. From 2016 to 2022, fourteen patients were treated with Lap-CRS-HIPEC with curative intent within the Italian centers. No conversion to open was observed. The median duration of surgery was 487.5 min. The median Peritoneal Cancer Index (PCI) was 3, and complete cytoreduction was achieved in all patients. Two patients (14.3%) had major postoperative complications, one requiring reintervention. After a median follow-up of 16.9 months, eleven patients were alive without disease (78.6%), two patients developed recurrence (14.3%), and one patient died for unrelated causes (7.1%). The literature review confirmed these results. In conclusion, current evidence shows that Lap-CRS-HIPEC is feasible, safe, and associated with a favorable outcome in selected patients. An accurate patient selection will continue to be paramount in choosing this treatment.
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Affiliation(s)
- Antonio Sommariva
- Advanced Surgical Oncology Unit, Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-423-421306
| | - Mario Valle
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Roberta Gelmini
- SC Chirurgia Generale d’Urgenza ed Oncologica, AOU Policlinico di Modena, 41125 Modena, Italy
| | - Marco Tonello
- Advanced Surgical Oncology Unit, Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy
| | - Fabio Carboni
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | | | - Lorena Sorrentino
- SC Chirurgia Generale d’Urgenza ed Oncologica, AOU Policlinico di Modena, 41125 Modena, Italy
| | - Enrico Maria Pasqual
- AOUD Center Advanced Surgical Oncology, DAME University of Udine, 33100 Udine, Italy
| | - Stefano Bacchetti
- AOUD Center Advanced Surgical Oncology, DAME University of Udine, 33100 Udine, Italy
| | - Cinzia Sassaroli
- Colorectal Surgical Oncology, Abdominal Oncology Department, “Fondazione Giovanni Pascale” IRCCS, 80131 Naples, Italy
| | - Andrea Di Giorgio
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy
| | - Massimo Framarini
- Surgery and Advanced Oncological Therapy Unit, Ospedale “GB.Morgagni-L.Pierantoni”—AUSL Forlì, 47121 Forlì, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery, and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, 53100 Siena, Italy
| | - Francesco Casella
- Upper GI Surgery Division, University of Verona, 37134 Verona, Italy
| | - Orietta Federici
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
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9
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Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a prospective clinical trial and comparative analysis. Surg Endosc 2022:10.1007/s00464-022-09589-w. [DOI: 10.1007/s00464-022-09589-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/25/2022] [Indexed: 12/12/2022]
Abstract
Abstract
Background
Open cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with high morbidity, which limits the degree to which patients may benefit from this therapy. This study aimed to determine the feasibility of laparoscopic CRS/HIPEC.
Methods
This was a single institution prospective clinical trial and comparative study using historical controls. Patients with histologically confirmed peritoneal surface malignancy (PSM) of appendiceal, colorectal, ovarian, or primary peritoneal origin, peritoneal carcinomatosis index (PCI) $$\le$$
≤
10 were eligible.
Results
Clinical trial: 18 patients (median age 57 years, 39% female) with appendiceal (15) or colorectal (3) primary PSM underwent laparoscopic CRS/HIPEC. Median and range outcomes were: operative time 219 min (134–378), EBL 10 mL (0–100), time to return to bowel function 3 days (1–7), duration IV narcotic use 3 days (1–8), length of stay 6 days (3–11). All patients had a complete cytoreduction (CC-score 0). Three (17%) experienced minor morbidity, with no major morbidity or mortality. Median DFS and OS were not reached with median follow-up of 48 months. Comparative analysis: Laparoscopic approach associated with reduced time to return of bowel function (3 versus 4 days, p = 0.001), length of stay (8 versus 5 days, p < 0.001), and morbidity (16% versus 42%, p = 0.008). Independent predictors of DFS included prior chemotherapy (HR 5.07, 95% CI 1.85, 13.89; p = 0.002), and CC-score > 0 (HR 3.31, 95% CI 1.19, 9.41; p = 0.025), but not surgical approach. CC-score > 0 was the only independent predictor of OS (HR 10.12, 95% CI 2.16, 47.30, p = 0.003).
Conclusions and relevance
Laparoscopic CRS/HIPEC should be considered for patients with PSM with low-volume disease, including those with adenocarcinoma histology.
Trial registration
Clinicaltrials.gov; NCT02463877.
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10
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Current Trends in Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Disease from Appendiceal and Colorectal Malignancies. J Clin Med 2022; 11:jcm11102840. [PMID: 35628966 PMCID: PMC9143396 DOI: 10.3390/jcm11102840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 12/10/2022] Open
Abstract
Peritoneal carcinomatosis (PC) is a poor prognostic factor for all malignancies. This extent of metastatic disease progression remains difficult to treat with systemic therapies due to poor peritoneal vascularization resulting in limited drug delivery and penetration into tissues. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are surgical interventions that directly target peritoneal tumors and have improved outcomes for PC resulting from appendiceal and colorectal cancer (CRC). Despite these radical therapies, long-term survival remains infrequent, and recurrence is common. The reasons for these outcomes are multifactorial and signal the need for the continued development of novel therapeutics, techniques, and approaches to improve outcomes for these patients. Here, we review landmark historical studies that serve as the foundation for current recommendations, recent discoveries, clinical trials, active research, and areas of future interest in CRS/HIPEC to treat PC originating from appendiceal and colorectal malignancies.
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11
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Chang SC, Fingerhut A, Chen WTL. Short and long-term outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for colorectal and appendiceal cancer peritoneal metastasis: Propensity score-matched comparison between laparoscopy vs. open approaches. Surg Oncol 2022; 43:101766. [DOI: 10.1016/j.suronc.2022.101766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 01/17/2023]
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12
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Shaltiel T, Solomon D, Pletcher ER, Golas BJ, Magge DR, Sarpel U, Labow DM, Cohen NA. Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is associated with improved perioperative outcomes: a single-center early experience propensity-matched analysis. Surg Endosc 2022; 36:6153-6161. [PMID: 35080674 DOI: 10.1007/s00464-022-09034-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The role of laparoscopy in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is not well established. Herein, we describe our early experience of laparoscopic CRS/HIPEC in patients with low-volume peritoneal disease compared to patients who underwent open CRS/HIPEC during the same time period. METHODS Using a prospectively maintained database, patients who underwent laparoscopic CRS/HIPEC were compared to a control cohort of patients who underwent open CRS/HIPEC, matched for peritoneal carcinomatosis index (PCI), completeness of cytoreduction, and tumor histology. RESULTS Between 2008 and 2017, 16 patients underwent laparoscopic CRS/HIPEC and were compared to a matched control cohort of 32 patients who underwent open CRS/HIPEC. Clinical and demographic data were similar between the groups. PCI, number of resected organs, and optimal cytoreduction rates were comparable. Patients who underwent laparoscopic experienced a lower estimated blood loss, (median, [IQR 1-3]); 150 mL, [50-300] vs. 100 mL, [50-125], p = 0.04, shorter length of stay (median [IQR 1-3]; 4 days [3-6] vs. 6 days [5-8], p < 0.01, and a lower 30-day complication rate (6.3% vs. 56.3%, p < 0.01). There was no difference in progression-free survival (p = 0.577) and overall survival (p = 0.472) between the groups. CONCLUSIONS This preliminary study demonstrates that laparoscopic CRS/HIPEC is feasible and safe for curative treatment in selected patients with low tumor volume. Minimally invasive CRS/HIPEC is associated with fewer postoperative complications and shorter length of stay. There was no difference in long-term oncological outcomes between the groups.
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Affiliation(s)
- Tali Shaltiel
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Daniel Solomon
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Eric R Pletcher
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Benjamin J Golas
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Deepa R Magge
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Umut Sarpel
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Daniel M Labow
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA
| | - Noah A Cohen
- Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA.
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13
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Cusumano C, Carrere S, Bouillin A, Nougaret S, Khellaf L, Quénet F, Sgarbura O. Laparoscopic cytoreductive surgery and HIPEC in LAMN with small volume of peritoneal disease: a valuable option of treatment for good patient-related experience measures (PREMs). Surg Endosc 2021; 36:4757-4763. [PMID: 34845545 DOI: 10.1007/s00464-021-08816-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 10/17/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the best effective treatment for pseudomyxoma peritonei (PMP). In the last years, the advances in histopathology have stratified PMP lesions in different degrees of aggressivity suggesting the possibility of a tailored treatment. In a subset of patients with small volume peritoneal disease, laparoscopic CRS and HIPEC is feasible. The aim of this study is to analyze the results of laparoscopic CRS + HIPEC in a monocentric series of patients under patient-related experience measures (PREMs). METHODS All consecutive patients who underwent laparoscopic CRS-HIPEC with curative intent at Cancer Institute of Montpellier were retrieved from a prospectively maintained database and analyzed. Selection criteria for laparoscopic approach were low-grade PMP with pathological confirmation prior to CRS-HIPEC, age < 75 years, no extra-peritoneal disease, peritoneal cancer index (PCI) < 10, and a limited history of abdominal surgery. A PREMS interview was conducted before analysis with all the included patients. Outcomes of interest included postoperative morbidity, medium-term survival, and PREMs. RESULTS Fourteen patients were operated on for low-grade PMP with a laparoscopic approach at our institution. Conversions to laparotomy were necessary in three patients, and postoperative complications were observed in three patients (Clavien 3b in one patient). In-hospital postoperative median stay was 9.5 days. No death or recurrence was observed during the study period. CONCLUSIONS Laparoscopic CRS-HIPEC for LAMN in presence of small peritoneal disease is feasible in terms of postoperative morbidity and mortality. According to our PREMs questionnaire, patients' expectations were satisfied.
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Affiliation(s)
- Caterina Cusumano
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de HautepierreHôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France
| | - Sébastien Carrere
- Department of Surgical Oncology, Cancer Institute Montpellier, University of Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France
| | - Alix Bouillin
- Department of Surgical Oncology, Cancer Institute Montpellier, University of Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France
| | - Stéphanie Nougaret
- Department of Radiology, Cancer Institute Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France
| | - Lakhdar Khellaf
- Department of Pathology, Cancer Institute Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France
| | - François Quénet
- Department of Surgical Oncology, Cancer Institute Montpellier, University of Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France
| | - Olivia Sgarbura
- Department of Surgical Oncology, Cancer Institute Montpellier, University of Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France. .,IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Institut Régional du Cancer de Montpellier, Université de Montpellier, 34298, Montpellier, France.
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14
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Kepenekian V, Péron J, Goéré D, Sgarbura O, Delhorme JB, Eveno C, Benzerdjeb N, Bonnefoy I, Villeneuve L, Rousset P, Abboud K, Pocard M, Glehen O. Multicystic peritoneal mesothelioma treated with cytoreductive surgery followed or not by hyperthermic intraperitoneal chemotherapy: results from a large multicentric cohort. Int J Hyperthermia 2021; 38:805-814. [PMID: 34039244 DOI: 10.1080/02656736.2021.1903585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Multicystic peritoneal mesothelioma (MCPM) is a rare, slowly growing, condition prone to recur after surgery. The role of hyperthermic intraperitoneal chemotherapy (HIPEC) added to complete cytoreductive surgery (CRS) remains controversial and difficult to assess. As patients are mostly reproductive age women, surgical approach, and fertility considerations are important aspects of the management. This observational retrospective review aimed to accurate treatment strategy reflections. METHODS The RENAPE database (French expert centers network) was analyzed over a 1999-2019 period. MCPM patients treated with CRS were included. A special focus on HIPEC, mini-invasive approach, and fertility considerations was performed. RESULTS Overall 60 patients (50 women) were included with a median PCI of 10 (4-14) allowing 97% of complete surgery, followed by HIPEC in 82% of patients. A quarter of patients had a laparoscopic approach. Twelve patients (20%) recurred with a 3-year recurrence free survival of 84.2% (95% confidence interval 74.7-95.0). The hazard of recurrence was numerically reduced among patients receiving HIPEC, however, not statistically significant (hazard ratio 0.41, 0.12-1.42, p = 0.200). A severe post-operative adverse event occurred in 22% of patients with five patients submitted to a subsequent reoperation. Among four patients with a childbearing desire, three were successful (two had a laparoscopic-CRS-HIPEC and one a conventional CRS without HIPEC). CONCLUSION MCPM patients treatment should aim at a complete CRS. The intraoperative treatment options as laparoscopic approach, fertility function sparing and HIPEC should be discussed in expert centers to propose the most appropriate strategy.
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Affiliation(s)
- Vahan Kepenekian
- Service de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.,EMR 3738, Lyon 1 University, Lyon, France
| | - Julien Péron
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Université Lyon 1, Villeurbanne, France.,Department of Oncology, Hospices Civils de Lyon, Lyon, France
| | - Diane Goéré
- Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Olivia Sgarbura
- Department of Surgical Oncology, Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Jean-Baptiste Delhorme
- Service de chirurgie générale et digestive, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,IRFAC, INSERM U1113, Strasbourg, France
| | - Clarisse Eveno
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, UMR-S1277 - CANTHER Laboratory "Cancer Heterogeneity, Plasticity and Resistance to Therapies", Lille, France
| | - Nazim Benzerdjeb
- Laboratoire d'Anatomie et Cytologie Pathologiques, Institut de Pathologie Multisite, Centre de Biologie Sud, Centre Hospitalier Sud, Hospices Civils de Lyon, Lyon, France
| | - Isabelle Bonnefoy
- Service de Recherche et Epidémiologie Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Laurent Villeneuve
- Service de Recherche et Epidémiologie Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Pascal Rousset
- EMR 3738, Lyon 1 University, Lyon, France.,Service d'Imagerie Médicale, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Karine Abboud
- Service de Chirurgie générale et thoracique. Centre hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Marc Pocard
- Université de Paris, INSERM UMR 1275 CAP Paris-Tech, Paris, France.,Service de chirurgie digestive et cancérologique, Hôpital Lariboisière, Paris, France
| | - Olivier Glehen
- Service de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.,EMR 3738, Lyon 1 University, Lyon, France
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15
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Arjona-Sánchez Á, Durán M, Rodríguez-Ortiz L, Rufián-Peña S, Briceño J. Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for a limited low-grade pseudomyxoma peritonei-a video vignette. Colorectal Dis 2021; 23:331-332. [PMID: 33070418 DOI: 10.1111/codi.15409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/25/2020] [Accepted: 10/10/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Álvaro Arjona-Sánchez
- Unit of Surgical Oncology, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain.,Research Group in Peritoneal and Retroperitoneal Oncologic Surgery, Maimonides Biomedical Research Institute (IMIBIC), Cordoba, Spain
| | - Manuel Durán
- Unit of Surgical Oncology, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain.,Translational Research in Surgery of Solid Organ Transplantation, Maimonides Biomedical Research Institute (IMIBIC), Cordoba, Spain
| | - Lidia Rodríguez-Ortiz
- Unit of Surgical Oncology, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain.,Research Group in Peritoneal and Retroperitoneal Oncologic Surgery, Maimonides Biomedical Research Institute (IMIBIC), Cordoba, Spain
| | - Sebastián Rufián-Peña
- Unit of Surgical Oncology, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain.,Research Group in Peritoneal and Retroperitoneal Oncologic Surgery, Maimonides Biomedical Research Institute (IMIBIC), Cordoba, Spain
| | - Javier Briceño
- Unit of Surgical Oncology, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain.,Translational Research in Surgery of Solid Organ Transplantation, Maimonides Biomedical Research Institute (IMIBIC), Cordoba, Spain
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16
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Rodríguez-Ortiz L, Arjona-Sánchez A, Ibañez-Rubio M, Sánchez-Hidalgo J, Casado-Adam A, Rufián-Peña S, Briceño-Delgado J. Laparoscopic cytoreductive surgery and HIPEC: a comparative matched analysis. Surg Endosc 2020; 35:1778-1785. [DOI: 10.1007/s00464-020-07572-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/15/2020] [Indexed: 12/12/2022]
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