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Ohorchak M, Yarema R, Mielko J, Fetsych T, Skorzewska M, Rawicz-Pruszyński K, Mashukov A, Maksimovsky V, Jastrzębski T, Gyrya P, Kovalchuk Y, Safiyan V, Kopetskiy V, Kondratskiy Y, Paskonis M, Polkowski W. A retrospective cooperative Central-Eastern European study of hyperthermic intraperitoneal chemotherapy (HIPEC) in treatment of locally advanced and intraperitonealy disseminated gastric cancer. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2021.12.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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2
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Jastrzębski T, Gościński M. HIPEC in Complementary Treatment to Cytoreductive Procedures: An Unexplained Issue After the PRODIGE 7 Trial. Ann Surg Oncol 2021; 28:803-805. [PMID: 34618245 DOI: 10.1245/s10434-021-10905-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Tomasz Jastrzębski
- Department of Oncological Surgery, Medical University Gdańsk, Gdańsk, Poland.
| | - Mariusz Gościński
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
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3
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Jastrzębski T, Richter P, Zegarski W, Dziki A, Wallner G, Jeziorski A, Wysocki W, Jackowski M, Bębenek M, Olesiński T, Polkowski W, Wyrwicz L, Wydra D, Biernat W, Czauderna P, Studniarek M, Polec T, Owczuk R, Sommer A, Szewczyk K, Mielko J. Guidelines of the Association of Polish Surgeons
and the Polish Society of Surgical Oncology on
the accreditation of healthcare centers providing
cytoreductive surgery and HIPEC for primary
and secondary peritoneal cancers. Pol Przegl Chir 2020. [DOI: 10.5604/01.3001.0014.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Surgical interventions in patients with peritoneal metastases combined with hyperthermic intraperitoneal chemotherapy
(HIPEC) and systemic treatment are becoming more common and, when applied to selected patient groups, they reach 5-year
survival rates of 32–52%. Good clinical outcomes require experienced and well-equipped healthcare centers, experienced
surgical team and adequate patient qualification process. As a result of the discussion on the need for evaluation of quality of
care and treatment outcomes and at the request of the Peritoneal Cancer Section of the Polish Society of Surgical Oncology,
accreditation standards have been developed and the Accreditation Committee has been established for healthcare centers
providing cytoreductive surgery and HIPEC for the management of primary and secondary peritoneal cancers.
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Affiliation(s)
| | - Piotr Richter
- General, Oncological, Gastroenterological and Transplant Surgery Clinical Department, University Hospital of the Jagiellonian University
| | | | - Adam Dziki
- Department of General and Colorectal Surgery, Medical University of Lodz
| | | | | | - Wojciech Wysocki
- Department of General, Oncological and Vascular Surgery, Fifth Military Hospital in Kraków
| | - Marek Jackowski
- Department of General and Gastrointestinal Surgery and Surgical Oncology, Nicolaus Copernicus University in Torun
| | - Marek Bębenek
- Surgical Oncology Department, Lower Silesian Oncology Center in Wroclaw
| | - Tomasz Olesiński
- Surgical Unit, Department of Gastrointestinal Oncology, Maria Sklodowska-Curie National Research Institute of Oncology
| | | | - Lucjan Wyrwicz
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology
| | - Dariusz Wydra
- Department of Gynecologic Oncology, Medical University of Gdansk
| | | | - Piotr Czauderna
- Department of Surgery and Pediatric Urology, Medical University of Gdansk
| | | | - Tomasz Polec
- Department of Surgical Oncology, Medical University of Gdansk
| | - Radosław Owczuk
- Department of Anesthesiology and Intensive Care Unit, Medical University of Gdansk
| | - Anna Sommer
- Department of Anesthesiology and Intensive Care Unit, Medical University of Gdansk
| | | | - Jerzy Mielko
- Department of Surgical Oncology, Medical University of Lublin
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Jastrzębski T, Richter P, Zegarski W, Dziki A, Wallner G, Jeziorski A, Wysocki W, Jackowski M, Bębenek M, Olesiński T, Polkowski W, Wyrwicz L, Wydra D, Biernat W, Czauderna P, Studniarek M, Polec T, Owczuk R, Sommer A, Szewczyk K, Mielko J. Guidelines of the Association of Polish Surgeons and the Polish Society of Surgical Oncology on the accreditation of healthcare centers providing cytoreductive surgery and HIPEC for primary and secondary peritoneal cancers. Pol Przegl Chir 2020; 92:47-53. [PMID: 33739301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Surgical interventions in patients with peritoneal metastases combined with hyperthermic intraperitoneal chemotherapy (HIPEC) and systemic treatment are becoming more common and, when applied to selected patient groups, they reach 5-year survival rates of 32-52%. Good clinical outcomes require experienced and well-equipped healthcare centers, experienced surgical team and adequate patient qualification process. As a result of the discussion on the need for evaluation of quality of care and treatment outcomes and at the request of the Peritoneal Cancer Section of the Polish Society of Surgical Oncology, accreditation standards have been developed and the Accreditation Committee has been established for healthcare centers providing cytoreductive surgery and HIPEC for the management of primary and secondary peritoneal cancers.
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Affiliation(s)
| | - Piotr Richter
- General, Oncological, Gastroenterological and Transplant Surgery Clinical Department, University Hospital of the Jagiellonian University
| | | | - Adam Dziki
- Department of General and Colorectal Surgery, Medical University of Lodz
| | | | | | - Wojciech Wysocki
- Department of General, Oncological and Vascular Surgery, Fifth Military Hospital in Kraków
| | - Marek Jackowski
- Department of General and Gastrointestinal Surgery and Surgical Oncology, Nicolaus Copernicus University in Torun
| | - Marek Bębenek
- Surgical Oncology Department, Lower Silesian Oncology Center in Wroclaw
| | - Tomasz Olesiński
- Surgical Unit, Department of Gastrointestinal Oncology, Maria Sklodowska-Curie National Research Institute of Oncology
| | | | - Lucjan Wyrwicz
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology
| | - Dariusz Wydra
- Department of Gynecologic Oncology, Medical University of Gdansk
| | | | - Piotr Czauderna
- Department of Surgery and Pediatric Urology, Medical University of Gdansk
| | | | - Tomasz Polec
- Department of Surgical Oncology, Medical University of Gdansk
| | - Radosław Owczuk
- Department of Anesthesiology and Intensive Care Unit, Medical University of Gdansk
| | - Anna Sommer
- Department of Anesthesiology and Intensive Care Unit, Medical University of Gdansk
| | | | - Jerzy Mielko
- Department of Surgical Oncology, Medical University of Lublin
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Yarema R, Mielko J, Fetsych T, Ohorchak M, Skorzewska M, Rawicz-Pruszyński K, Mashukov A, Maksimovsky V, Jastrzębski T, Polkowski W, Gyrya P, Kovalchuk Y, Safiyan V, Karelin I, Kopetskiy V, Kolesnik O, Kondratskiy Y, Paskonis M. Hyperthermic intraperitoneal chemotherapy (HIPEC) in combined treatment of locally advanced and intraperitonealy disseminated gastric cancer: A retrospective cooperative Central-Eastern European study. Cancer Med 2019; 8:2877-2885. [PMID: 31033239 PMCID: PMC6558472 DOI: 10.1002/cam4.2204] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/10/2019] [Indexed: 02/06/2023] Open
Abstract
Background and Objectives Clinical experience in Western Europe suggests that cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are promising methods in the management of gastric cancer (GC) with peritoneal metastases. However, there are almost no data on such treatment results in patient from Central‐Eastern European population. Methods A retrospective cooperative study was performed at 6 Central‐Eastern European HIPEC centers. HIPEC was used in 117 patients for the following indications: treatment of GC with limited overt peritoneal metastases (n = 70), adjuvant setting after radical gastrectomy (n = 37) and palliative approach for elimination of severe ascites without gastrectomy (n = 10). Results Postoperative morbidity and mortality rates were 29.1% and 5.1%, respectively. Median overall survival in the groups with therapeutic, adjuvant, and palliative indications was 12.6, 34, and 3.5 months. The only long‐term survivors occurred in the group with peritoneal cancer index (PCI) of 0‐6 points without survival difference in groups with PCI 7‐12 vs PCI 13 or more points. Conclusions GC patients with limited peritoneal metastases can benefit from CRS + HIPEC. Hyperthermic intraperitoneal chemotherapy could be an effective method of adjuvant treatment of GC with a high risk of intraperitoneal progression. No long‐term survival may be expected after palliative approach to HIPEC.
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Affiliation(s)
- Roman Yarema
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | | | - Taras Fetsych
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Myron Ohorchak
- Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | | | | | | | | | | | | | - Petro Gyrya
- Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | - Yuriy Kovalchuk
- Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | - Victor Safiyan
- Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | - Ivan Karelin
- Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | | | | | | | - Marius Paskonis
- Vilnius universtiy hospital Santaros klinikos, Vilnius, Lithuania
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Yarema R, Mielko J, Fetsych T, Rawicz-Pruszyński K, Ohorchak M, Mashukov A, Maksimovsky V, Jastrzębski T, Gyrya P, Kovalchuk Y, Safiyan V, Karelin I, Kopetskiy V, Kondratskiy Y, Paskonis M, Polkowski W. Hyperthermic intraperitoneal chemotherapy (HIPEC) in combined treatment of locally advanced and intraperitonealy disseminated gastric cancer: A retrospective cooperative Central-Eastern European study. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Jastrzębski T, Bębenek M. Peritoneal metastases of colorectal origin - cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The financial aspect. Pol Przegl Chir 2018; 89:1-6. [PMID: 29335393 DOI: 10.5604/01.3001.0010.6733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The incidence of peritoneal carcinomatosis of colorectal cancer amounts to 5%-15% for synchronous metastases and as much as 40% in cases of local recurrence. Best results are obtained for cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment offers much better outcomes, leading to 5-year survival rates of as much as 30%-50%. The procedures require significant experience in abdominal surgery, are time-consuming (mean duration of the procedure ranging from 6 to 8 hours) and are burdened by complications that are due not only to the procedure itself but also to the intraperitoneal administration of the cytostatic drug at elevated temperature (41.5 °C). After the procedure, patients are required to be admitted to intensive care units due to potential complications associated with the extent and duration of the procedure as well as chemotherapy administered in hyperthermia. Postoperative management of these patients requires appropriate experience of the entire medical and nursing team. Cytoreductive surgeries combined with HIPEC as highly specialized medical procedures should be assessed for their potential long-term benefits and their costs should be appropriately calculated with consideration to realistic reimbursement rates. Realistic valuation and reimbursement covering the overall average cost of the procedure is recommended by the National Consultant in Surgical Oncology as well as the ESMO consensus guidelines.
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Affiliation(s)
| | - Marek Bębenek
- Department of Surgical Oncology, Lower Silesian Oncology Center, Wrocław
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Abstract
Częstość przerzutów do otrzewnej w raku jelita grubego wynosi 5%-15% w przypadku przerzutów synchronicznych i aż 40% w przypadku wystąpienia wznowy miejscowej. Najlepsze wyniki leczenia uzyskuje się poprzez skojarzone wykonanie zabiegu cytoredukcyjnego w połączeniu z dootrzewnową chemioterapią perfuzyjną w hipertermii (HIPEC). Wyniki takiego leczenia są zdecydowanie lepsze i pozwalają na osiągnięcie przeżyć 5-letnich na poziomie 30%-50%. Zabiegi te wymagają dużego doświadczenia w chirurgii jamy brzusznej, są czasochłonne (średni czas procedury chirurgicznej wynosi 6-8 godzin) i obarczone powikłaniami związanymi nie tylko z zabiegiem operacyjnym, ale także podaniem cytostatyku do jamy otrzewnej w podwyższonej temperaturze (41,5 st. C). Chorzy po zabiegu wymagają pobytu na oddziale intensywnej terapii, co jest związane z wystąpieniem potencjalnych powikłań spowodowanych rozległością zabiegu, długością procedury chirurgicznej, zastosowaniu chemioterapii w połączeniu z hipertermią. Prowadzenie pooperacyjne tych chorych wymaga doświadczenia całego zespołu lekarskiego i pielęgniarskiego. Zabiegi cytoredukcyjne w połączeniu z HIPEC jako wysoce specjalistyczne procedury medyczne powinny być merytorycznie ocenione pod kątem korzyści długoterminowych dla chorych i odpowiednio skalkulowane pod względem realnej wysokości refundacji. Jako procedura zalecana w wytycznych Kionsultanta Krajowego d.s. Chirurgii Onkologicznej oraz wytycznych ESMO, niezbędna jest jej realna wycena i refundacja pokrywająca jej całkowite średnie koszty.
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Affiliation(s)
| | - Wojciech Zegarski
- Clinic of Oncological Surgery, Ludwik Rydygier Collegium Medicum UMK in Toruń, Center of Oncology in Bydgoszcz
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Kabata P, Jastrzębski T, Kąkol M, Król K, Bobowicz M, Kosowska A, Jaśkiewicz J. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition--prospective randomized controlled trial. Support Care Cancer 2014; 23:365-70. [PMID: 25091056 PMCID: PMC4289010 DOI: 10.1007/s00520-014-2363-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 07/21/2014] [Indexed: 02/02/2023]
Abstract
Purpose Preoperative nutrition is beneficial for malnourished cancer patients. Yet, there is little evidence whether or not it should be given to nonmalnourished patients. The aim of this study was to assess the need to introduce preoperative nutritional support in patients without malnutrition at qualification for surgery. Methods This was a prospective, two-arm, randomized, controlled, open-label study. Patients in interventional group received nutritional supplementation for 14 days before surgery, while control group kept on to their everyday diet. Each patient’s nutritional status was assessed twice—at qualification (weight loss in 6 months, laboratory parameters: albumin, total protein, transferrin, and total lymphocyte count) and 1 day before surgery (change in body weight and laboratory parameters). After surgery, all patients were followed up for 30 days for postoperative complications. Results Fifty-four patients in interventional and 48 in control group were analyzed. In postoperative period, patients in control group suffered from significantly higher (p < 0.001) number of serious complications compared with patients receiving nutritional supplementation. Moreover, levels of all laboratory parameters declined significantly (p < 0.001) in these patients, while in interventional arm were stable (albumin and total protein) or raised (transferrin and total lymphocyte count). Conclusions Preoperative nutritional support should be introduced for nonmalnourished patients as it helps to maintain proper nutritional status and reduce number and severity of postoperative complications compared with patients without such support.
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Affiliation(s)
- Paweł Kabata
- Department of Surgical Oncology, Medical University of Gdańsk, Smoluchowskiego 17, 80-952, Gdańsk, Poland,
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Makarewicz W, Jaworski Ł, Bobowicz M, Roszak K, Jaroszewicz K, Rogowski J, Jastrzębski T, Jaśkiewicz J. Paraesophageal Hernia Repair Followed by Cardiac Tamponade Caused by ProTacks. Ann Thorac Surg 2012; 94:e87-9. [DOI: 10.1016/j.athoracsur.2012.03.107] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 03/11/2012] [Accepted: 03/23/2012] [Indexed: 10/27/2022]
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Zieliński J, Kopacz A, Jastrzębski T, Świerblewski M, Kruszewski W, Rzepko R. 207. Próba oceny „węzła wartownika” w raku odbytnicy metodą barwnikową. Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70691-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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