Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in the Management of Peritoneal Surface Malignancies of Colonic Origin: A Consensus Statement

Esquivel, Jesús; Sticca, Robert P.; Sugarbaker, Paul H.; Levine, Edward A.; Yan, Tristan D.; Alexander, Richard B.; Baratti, Dario; Bartlett, David L.; Barone, Robert M.; Barrios, P.; Bieligk, Samuel; Bretcha-Boix, Pedro; Chang, C. K.; Chu, Francis; Chu, Quyen D.; Daniel, Steve; DeBree, Eelco; Deraco, Marcello; Domínguez-Parra, Luis Manuel; Élias, Dominique; Flynn, R.; Foster, Jason M.; Garofalo, Alfredo; Gilly, François Noël; Gléhen, Olivier; Gómez-Portilla, Alberto; González-Bayón, L.; González-Moreno, Santiago; Goodman, Martin; Gushchin, Vadim; Hanna, Nader; Hartmann, J. T.; Harrison, Lawrence E.; Hoefer, R.; Kane, John M.; Kecmanović, Dragutin; Kelley, Scott T.; Kuhn, Joseph A.; Lamont, Jeffery; Lange, Julie R.; Li, B.; Loggie, Brian; Mahteme, Haile; Mann, Gary N.; Martin, Robert; Misih, R. A.; Moran, B.; Morris, David L.; Oñate‐Ocaña, Luis F.; Petrelli, Nicholas J.; Philippe, G.; Pingpank, James F.; Pitroff, A.; Piso, Pompiliu; Quinones, M.; Riley, Lee B.; Rutstein, Lisa A.; Saha, Suranjit Kumar; Alrawi, Sadir; Sardi, Armando; Schneebaum, Schlomo; Shen, Perry; Shibata, David; Spellman, J.; Stojadinovic, Alexander; Stewart, John H.; Torres-Melero, J; Tuttle, Todd M.; Verwaal, Vic J.; Villar, Jesús; Wilkinson, Neal; Younan, Rami; Zeh, Herbert J.; Zoetmulder, F.A.N.; Sebbag, Gilbert

doi:10.1245/s10434-007-9599-x

Cited by 119 publications

(174 citation statements)

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“…However, during HIPEC, body temperature rises considerably because of the circulation of the heated solution, and it reaches levels of 388C or more, leading to a significantly increased metabolic rate. 15,16 This was also observed in our series, with temperatures that reached mean values of 37.88C at the end of HIPEC. Different cooling measures are necessary at this time to avoid central hyperthermia-measures such as intravenous administration of cold crystalloids, placement of ice packs around patient's head and neck, and turning off the air heating blankets.…”

Section: Discussionsupporting

confidence: 87%

Hemodynamic Monitoring During Heated Intraoperative Intraperitoneal Chemotherapy Using the FloTrac/Vigileo System

Mavroudis¹,

Alevizos²,

Stamou³

et al. 2015

International Surgery

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Cytoreductive surgery with HIPEC has provided a chance for long-term survival in selected patients. However, perioperative management remains a challenge for the anesthesiology team. The aim of this study was to evaluate the changes in hemodynamic parameters during hyperthermic intraperitoneal chemotherapy (HIPEC) using the FloTrac/ Vigileo system. Forty-one consecutive patients undergoing cytoreductive surgery and HIPEC were enrolled. Heart rate (HR), esophageal temperature, and cardiac output (CO) steadily increased until the end of HIPEC. In the first half of HIPEC, systolic blood pressure (SBP) and central venous pressure (CVP) increased whereas systemic vascular resistance (SVR) decreased; SVR stabilized in the second half. Diastolic blood pressure (DBP), mean arterial pressure (MAP), and stroke volume (SV) showed no significant variation. Male gender was related to increased CVP, CO, and SV, and decreased SVR; age .55 years was related to increased SBP, and peritoneal cancer index (PCI) was correlated with HR, DBP, and SV. PCI .14 was associated with increased HR and decreased DBP and MAP. American Society of Anesthesiologists score .1 was related to decreased CO and SV. Patients undergoing HIPEC develop a hyperdynamic circulatory state because of the increased temperature, characterized by a steady decrease in SVR and continuous increase in HR and CO. FloTrac/Vigileo system may provide an easy-to-handle, noninvasive monitoring tool.

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Section: Discussionsupporting

confidence: 87%

Hemodynamic Monitoring During Heated Intraoperative Intraperitoneal Chemotherapy Using the FloTrac/Vigileo System

Mavroudis¹,

Alevizos²,

Stamou³

et al. 2015

International Surgery

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“…5,31 In a consensus statement following the Society of Surgical Oncology Annual Meeting in 2006 it was advised that all patients suffering from peritoneal carcinomatosis should be eligible for such treatment in whom a complete cytoreduction can be achieved in the absence of systemic metastases. 32 In our study, from 2006 onward, indeed a growing proportion of patients has been treated by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy (11%). Future studies will have to monitor the effect of a growing proportion of patients undergoing this procedure on population-based survival of patients with peritoneal carcinomatosis.…”

Section: Epidemiologymentioning

confidence: 64%

“…This underlines the importance of initiating studies on new treatment strategies for this population. [32][33][34][35] …”

Section: Epidemiologymentioning

confidence: 99%

Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: A population‐based study

Lemmens

Klaver

Verwaal

et al. 2010

Intl Journal of Cancer

291

208

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The aim of our study was to provide population‐based data on incidence and prognosis of synchronous peritoneal carcinomatosis and to evaluate predictors for its development. Diagnosed in 1995–2008, 18,738 cases of primary colorectal cancer were included. Predictors of peritoneal carcinomatosis were analysed by multivariable logistic regression analysis. Median survival in months was calculated by site of metastasis. In the study period, 904 patients were diagnosed with synchronous peritoneal carcinomatosis (4.8% of total, constituting 24% of patients presenting with M1 disease). The risk of peritoneal carcinomatosis was increased in case of advanced T stage [T4 vs. T1,2: odds ratio (OR) 4.7, confidence limits 4.0–5.6), advanced N stage [N0 vs. N1,2: OR 0.2 (0.1–0.2)], poor differentiation grade [OR 2.1 (1.8–2.5)], younger age [<60 years vs. 70–79 years: OR 1.4 (1.1–1.7)], mucinous adenocarcinoma [OR 2.0 (1.6–2.4)] and right‐sided localisation of primary tumour [left vs. right: OR 0.6 (0.5–0.7)]. Median survival of patients with peritoneum as single site of metastasis remained dismal [1995–2001: 7 (6–9) months; 2002–2008: 8 (6–11) months], contrasting the improvement among patients with liver metastases [1995–2001: 8 (7–9) months; 2002–2008: 12 (11–14) months]. To conclude, synchronous peritoneal metastases from colorectal cancer are more frequent among younger patients and among patients with advanced T stage, mucinous adenocarcinoma, right‐sided tumours and tumours that are poorly differentiated. The prognosis of synchronous peritoneal carcinomatosis remains poor with a median survival of 8 months and even worse if concomitant metastases in other organs are present.

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“…[10,11] These studies show the efficacy of CRS and HIPEC in treating colorectal PC and many medical and surgical oncologists will now routinely refer patients with colorectal PC for this treatment. [12][13][14] However, there still remains controversy concerning this treatment. [15,16] This is partly due to the small number of larger studies published and only one randomised trial evaluating both CRS and IPC together against systemic chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis: Prognosis and treatment of recurrences in a cohort study

Cashin

Graf

Nygren

et al. 2012

European Journal of Surgical Oncology (EJSO)

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Background Cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) treatment of colorectal peritoneal carcinomatosis (PC) is gaining acceptance, but controversy remains. The primary aims were to analyze the outcome and prognostic variables of colorectal PC patients treated with CRS and IPC, and to report on the outcome of additional surgical treatments of subsequent recurrences. MethodsPatients referred for treatment of colorectal PC between 1996 and 2010 were included in a cohort. The following data was collected: clinicopathological parameters, survival, recurrences, perioperative chemotherapy and type of IPC (hyperthermic intraperitoneal chemotherapy, HIPEC; or sequential postoperative intraperitoneal chemotherapy, SPIC). Multivariable analyses were conducted on potential prognostic factors for overall survival (OS). ResultsIn the 151-patient cohort, the median OS was 34months (range: 2-77) for CRS and HIPEC with five-year survival predicted at 40% (five-year disease-free survival 32%). For CRS and SPIC, the OS was 25months (range: 2-188) with five-year survival at 18%. Open-and-close patients survived 6months (range: 0-14) with no five-year survival (HIPEC vs. SPIC p=0.047,. Adjuvant systemic chemotherapy was a noteworthy independent prognostic factor in the multivariable analysis. OS for patients undergoing additional surgical treatment of recurrences was 25months vs. 10months with best supportive care or palliative chemotherapy (p=0.01). ConclusionSubstantial long-term survival is possible in patients with colorectal PC. HIPEC was associated with better OS than SPIC and adjuvant systemic chemotherapy may improve the outcome in patients. Good OS is achievable in selected patients undergoing additional surgical treatment of isolated liver or peritoneal recurrences after prior complete CRS.

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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in the Management of Peritoneal Surface Malignancies of Colonic Origin: A Consensus Statement

Cited by 119 publications

References 0 publications

Hemodynamic Monitoring During Heated Intraoperative Intraperitoneal Chemotherapy Using the FloTrac/Vigileo System

Hemodynamic Monitoring During Heated Intraoperative Intraperitoneal Chemotherapy Using the FloTrac/Vigileo System

Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: A population‐based study

Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis: Prognosis and treatment of recurrences in a cohort study

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