425. Survival prognostic factors in patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery and intraoperative hyperthermic intraperitoneal chemotherapy: A single institution experience

Nikolić, Srdjan; Zegarac, Z.M.; Martinovic, Mia; Djurisic, Igor; Kocić, M.; Marković, Ivana

doi:10.1016/j.ejso.2014.08.415

Cited by 5 publications

(8 citation statements)

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“…An additional treatment protocol each was described for the combination of MMC with 5-fluorouracil (5-FU) [125], the active irinotecan (IRI) metabolite hydroxycamptothecin (HCPT) [126] and etoposide (ETO) [119] (Table S7). Using single-agent oxaliplatin (L-OHP), at least twelve different manners of drug dosing were described in 44 articles published between 2002 and 2017 (Table S4) [28,31,32,33,34,35,54,55,60,65,66,69,72,75,76,81,82,91,108,111,116,121,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148]. Between 2004 and 2016 seven articles were published, outlining four diverse ways of dosing a combination of L-OHP and IRI (Table S5) [32,83,134,140,144,149,150].…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer

Yurttas¹,

Hoffmann²,

Tolios

et al. 2018

JCM

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Background: Cytoreductive surgery (CRS), followed by hyperthermic intraperitoneal chemotherapy (HIPEC), combines radical surgery with abdominal heated chemotherapy, constituting a multimodal treatment approach. Since clear standards for HIPEC conduct in colorectal carcinoma (CRC) are lacking, we aimed to provide a comprehensive structured survey. Data sources and study eligibility criteria: A systematic literature search was performed in PubMed, with keywords “HIPEC” and “colorectal cancer”, according to established guidelines. Articles were systematically screened, selecting 87 publications complemented by 48 publications identified through extended search for subsequent synthesis and evaluation, extracting inter alia details on used drugs, dosage, temperature, exposure times, and carrier solutions. Results: Compiled publications contained 171 reports on HIPEC conduct foremost with mitomycin C and oxaliplatin, but also other drugs and drug combinations, comprising at least 60 different procedures. We hence provide an overview of interconnections between HIPEC protocols, used drugs and carrier solutions as well as their volumes. In addition, HIPEC temperatures and dosing benchmarks, as well as an estimate of in vivo resulting drug concentrations are demonstrated. Conclusions and implications: Owing to recent developments, HIPEC conduct and practices need to be reassessed. Unfortunately, imprecise and lacking reporting is frequent, which is why minimal information requirements should be established for HIPEC and the introduction of final drug concentrations for comparability reasons seems sensible.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer

Yurttas¹,

Hoffmann²,

Tolios

et al. 2018

JCM

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“…PCI has been one of the most consistent independent predictors of morbidity and mortality from CRS-HIPEC. 2,[5][6][7][8][9] There has, however, been no consensus on a PCI cut off in CPM that predicts poorer post-operative outcomes, with studies thus far reporting a wide range (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) that are significantly predictive of DFS and OS. 6,8,[10][11][12] Results from our study suggest that for patients with PC from colorectal primaries, a lower cut-off value of 7-11 is a satisfactorily significant predictor of postoperative OS.…”

Section: Discussionmentioning

confidence: 99%

“…Other parameters reported to be significantly predictive of survival outcomes include gender, age, hypoalbuminaemia, carcinoembryonic antigen and Eastern Co-operative Oncology Group status. 7,14 These have been hotly disputed with an equally sizable number of contradictory studies.…”

Section: Discussionmentioning

confidence: 99%

Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis

Chin

Tan

Chia

et al. 2020

ANZ Journal of Surgery

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Background: This study aimed to determine pre-and peri-operative parameters with significant predictive value for post-operative outcomes in patients with recurrent colorectal cancer presenting as peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), and to develop a novel prognostic scoring system for prediction of survival outcomes. Methods: A single-institution review of prospectively collected data from all patients who underwent CRS-HIPEC between October 2005 and October 2017 was conducted. Univariate and multivariate analyses were used to identify significant parameters for prediction of post-CRS-HIPEC disease-free survival and overall survival (OS). Results: A total of 278 patients underwent CRS-HIPEC, of whom 72 were for peritoneal carcinomatosis from recurrent colorectal cancer. Disease-free interval (DFI; P = 0.006), peritoneal cancer index (PCI; P = 0.001) and left upper quadrant disease (P = 0.023) were significant independent predictors of 3-year OS. DFI (0.007), PCI (P < 0.001) and intraoperative blood loss (BL; P = 0.001) were significant independent predictors of 5-year OS. PCI and BL were significant independent predictors of both 3-year (P = 0.026, PCI; P = 0.009, BL) and 5-year (P = 0.002, PCI; P = 0.011, BL) disease-free survival. Predictive models were developed for risk stratification of OS. Conclusion: PCI, DFI, left upper quadrant disease and BL have significant predictive value for post-CRS-HIPEC outcomes. Risk stratification models allow for more prudent patient selection and ultimately more accurate prognostication of post-operative outcomes.

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“…To our knowledge, this study provides the first snapshot of perceptions among colorectal surgeons in Australia and New Zealand in the management of CRPM. CRS and HIPEC is a complex procedure, with major morbidity and mortality rates ranging from 13.1-47.2% and 1.0-4.1%, respectively [9,14]. Numerous studies have demonstrated a consistent relationship between high volume centres and improved long term survival after cancer surgery [15,16].…”

Section: Discussionmentioning

confidence: 99%

Perceptions in the management of colorectal peritoneal metastases: A bi-national survey of colorectal surgeons

Narasimhan

Warrier

Michael

et al. 2019

Pleura and Peritoneum

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BackgroundThere is great variability in the uptake of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of colorectal peritoneal metastases (CRPM) in Australia and New Zealand. This study aims to provide a snapshot of perceptions among colorectal surgeons in the management of CRPM.MethodsA structured ten-question online survey was sent to all colorectal surgeons, with three questions on clinical experience and demographics, one on health economics and six on hypothetical clinical scenarios. Scores were collated and reported based on Likert scales.ResultsEighty-one respondents (36.2%) completed the survey. Most surgeons (66.7%) strongly disagreed with offering CRS and HIPEC at all hospitals. The majority (87.7%) agreed that CRS and HIPEC offered a higher survival benefit than systemic chemotherapy in pseudomyxoma peritonei (PMP), and 69.1% in CRPM (comparators: 60.5% ovarian cancer, 14.8% gastric cancer). There were mixed strategies in managing low-volume, isolated peritoneal recurrences. The majority did not recommend second-look laparoscopy, but favoured operative management of Krukenberg tumours. In the presence of incidental peritoneal metastases, only 29.6% favoured biopsy only and referring the patient to a peritoneal disease centre.ConclusionsResponse rate was relatively low. In Australia and New Zealand, colorectal surgeons see a strong role for CRS and HIPEC in the management of PMP and CRPM. The role of “second look” surgery in high-risk cases is controversial and not supported. Krukenberg tumours are viewed as surgical disease. Regular updates and collaboration with peritoneal centres may help surgeons stay abreast with latest evidence in the field.

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425. Survival prognostic factors in patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery and intraoperative hyperthermic intraperitoneal chemotherapy: A single institution experience

Cited by 5 publications

References 0 publications

Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer

Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer

Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis

Perceptions in the management of colorectal peritoneal metastases: A bi-national survey of colorectal surgeons

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