Assessment of Hyperthermic Intraperitoneal Chemotherapy to Eradicate Intraperitoneal Free Cancer Cells

Abstract

OBJECTIVE: To assess the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) to eradicate intraperitoneal free cancer cells and to explore the feasibility of cytological cure for peritoneal carcinomatosis (PC). METHODS: The peritoneal lavage fluid (or ascites) from 50 PC patients was collected before and after intraoperative HIPEC, respectively, for conventional cytology test, and conventional and real-time quantitative reverse transcript polymerase chain reaction detecting carcinoembryonic antigen (CEA) mRNA and cytokeratin-20 (CK20) mRNA. The blood samples 3 days before and 7 days after intraoperative HIPEC were also collected for detecting the serum tumor markers, including CEA, carbohydrate antigen (CA) 125, and CA19-9. RESULTS: The positive rate of conventional cytology test before HIPEC versus after HIPEC was100.0% versus 22.0% (P = .000). The positive rates of CEA mRNA and CK20 mRNA before HIPEC versus after HIPEC were 100.0% versus 86.0% (P = .012) and 100.0% versus 96.0% (P = .495), respectively. Moreover, after HIPEC, 18 (36.0%) patients had a decline in CEA mRNA (P = .000), and 17 (34.0%) patients had a decline in CK20 mRNA (P = .000). The positive rates of serum CEA, CA125, and CA199 before HIPEC versus after HIPEC were 52.0% versus 28.0% (P = .014), 52.0% versus 44.0% (P = .423), and 40.0% versus 28.0% (P = .205), respectively. CONCLUSION: HIPEC could effectively eradicate intraperitoneal free cancer cells and partially achieve cytological cure for PC.

Intraperitoneal free cancer cells in gastric cancer: pathology of peritoneal carcinomatosis and rationale for intraperitoneal chemotherapy/hyperthermic intraperitoneal chemotherapy in gastric cancer

“…IFCCs are the recognized root pathologic cause for PC and the technique of detecting IFCCs has been developed in recent years. Ji et al (5) tried to assess the efficacy of HIPEC by detecting pre-and post-HIPEC IFCCs viability using traditional cytological method and RT-PCR method. This new method makes it possible to rapidly evaluate the efficacy of IPC/HIPEC, and it can be used in routine clinical setting to evaluate patients' response to IPC/HIPEC and predict the prognosis, and in preclinical research of evaluate new chemotherapeutic agents or new treatment strategies.…”

“…Intraperitoneal free cancer cells (IFCCs), first exfoliating from primary tumor mass to the abdominal cavity, then attaching to peritoneal surface, and finally invading into the subperitoneal tissue to form proliferating nodules, are the most fundamental pathophysiology for both synchronous and metachronous PC (5,6).…”

Peritoneal cancer index (PCI) based patient selecting strategy for complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in gastric cancer with peritoneal metastasis: A single-center retrospective analysis of 125 patients

“…According to Sugarbaker criteria [4], CC-1 was defined as the residual tumor nodule less than 2.5 mm, approaching the effective range of HIPEC. We demonstrated that HIPEC could effectively eradicate intraperitoneal cancer cells in only 80% patients with peritoneal carcinomatosis [21]. Therefore, CC-0 and CC-1 should be analyzed separately when assessing CRS in the treatment of peritoneal carcinomatosis theoretically.…”

Recent Advancements in Nanosystem-Based Molecular Beacons for RNA Detection and Imaging

“…For example, some reports have pointed out the detection of alpha-fetoprotein (AFP) mRNA can be used for early diagnosis of liver cancer, and it can guide for predicting the metastasis of liver cancer cells . There are also some studies have demonstrated that the detection of circulating cytokeratin mRNA, CD44 mRNA, and CK19 mRNA can be used as a tool for evaluating tumor treatment efficacy, which has great significance to evaluate the prognosis of treatment . In addition, the detection of carcinoembryonic antigen (CEA) mRNA had been used to evaluate the therapeutic effect of gastric cancer, lung cancer, and breast cancer …”