Cytoreductive surgery and perioperative intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colonic origin: outcomes after 7 years’ experience of a new centre for peritoneal surface malignancies

Bretcha-Boix, Pedro; Farré-Alegre, Jose; Sureda, Manuel; Dussan, Carlos; Ruixo, Juan José Pérez; Masllorens, Antonio Brugarolas

doi:10.1007/s12094-010-0531-7

Cited by 25 publications

(25 citation statements)

References 37 publications

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“…The study was approved by the corresponding Investigational Review Board and informed consent was obtained from each subject after being advised of the potential risks and benefits, as well as, the investigational nature of the study (31). The primary tumor type of the eligible patients were ovarian (n=10), colorectal (n=9), appendiceal (n=5), gastric (n=3), endometrial (n=2), and primary papilar (n=1).…”

Section: Methodsmentioning

confidence: 99%

Pharmacokinetic and Pharmacodynamic Analysis of Hyperthermic Intraperitoneal Oxaliplatin-Induced Neutropenia in Subjects with Peritoneal Carcinomatosis

Valenzuela

Nalda-Molina

Bretcha-Boix

et al. 2011

AAPS J

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Abstract. The objective of this study was to characterize the pharmacokinetics and the time course of the neutropenia-induced by hyperthermic intraperitoneal oxaliplatin (HIO) after cytoreductive surgery in cancer patients with peritoneal carcinomatosis. Data from 30 patients who received 360 mg/m 2 of HIO following cytoreductive surgery were used for pharmacokinetic-pharmacodynamic (PK/PD) analysis. The oxaliplatin plasma concentrations were characterized by an open two-compartment pharmacokinetic model after first-order absorption from peritoneum to plasma. An oxaliplatin-sensitive progenitor cell compartment was used to describe the absolute neutrophil counts in blood. The reduction of the proliferation rate of the progenitor cells was modeled by a linear function of the oxaliplatin plasma concentrations. The typical values of oxaliplatin absorption and terminal half-lives were estimated to be 2.2 and 40 h, with moderate interindividual variability. Oxaliplatin reduced the proliferation rate of the progenitor cells by 18.2% per mg/L. No patient's covariates were related to oxaliplatin PK/PD parameters. Bootstrap and visual predictive check evidenced the model was deemed appropriate to describe oxaliplatin pharmacokinetics and the incidence and severity of neutropenia. A peritoneum oxaliplatin exposure of 65 and 120 mg·L/h was associated with a 20% and 33% incidence of neutropenia grade 4. The time course of neutropenia following HIO administration was well described by the semiphysiological PK/PD model. The maximum tolerated peritoneum oxaliplatin exposure is 120 mg L/h and higher exposures should be avoided in future studies. We suggest the prophylactic use of granulocyte colony stimulating factor for patients treated with HIO exposure higher than 65 mg L/h.

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Section: Methodsmentioning

confidence: 99%

Pharmacokinetic and Pharmacodynamic Analysis of Hyperthermic Intraperitoneal Oxaliplatin-Induced Neutropenia in Subjects with Peritoneal Carcinomatosis

Valenzuela

Nalda-Molina

Bretcha-Boix

et al. 2011

AAPS J

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“…The procedure of CRS and HIPEC in treating PC arising from different organs is gaining momentum with more institutions acquiring technical support and expertise in various parts of world. Reports from single institutions are published for example in 11 patients from Arizona; [5] 12 patients with irinotecan and mitomycin -Phase I study from France; [6] 20 patients from 2001 to 2008 with follow-up of 8-28 months from Spain; [7] 21 patients followed for 43 months from China; [8] 22 patients from 2007 to 2010 followed for 35 months from Croatia; [9] 26 patients from 2007 to 2011 from Mexico. [10] Peritoneal carcinomatosis is often fatal.…”

Section: Resultsmentioning

confidence: 99%

Initial experience with hyperthermic intra peritoneal chemotherapy and cytoreductivesurgery

Dharmadhikari¹,

Shah²,

Jagannath³

2014

Indian J Cancer

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“…The combination CRS+HIPEC to treat for colorectal peritoneal carcinomatosis leads to a survival rate of 5 years, similar to that published for the resection of liver metastases of the same origin 9 . The standardization of treatment protocols, as well as multicentric studies, have been proposed to better understand this therapy and to optimize clinical results 8 . CRS+HIPEC are currently doable procedures that tend to increase survival.…”

Section: Resultsmentioning

confidence: 99%

“…PCI, unfavorable compromised locations, presence of liver metastases and complete cytoreduction can be understood as independent prognostic factors correlated with survival 1,4,7,8 . Some studies have shown that PCI>13 (in cases of colorectal cancer) and incomplete cytoreduction have a reserved prognosis.…”

Section: Discussionmentioning

confidence: 99%

Multimodal treatment of peritoneal malignancies - results of the implantation in a tertiary hospital

Rabelo

Queiroz

Rêgo

et al. 2012

J. Coloproctol. (Rio J.)

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106Rabelo FEF, Queiroz FL, Rego RSN, Costa BXM, Lamounier PCC, Oliveira TAN, Lacerda Filho A, Paiva RA. Multimodal treatment of peritoneal malignancies -results of the implantation in a tertiary hospital. J Coloproctol, 2012;32(2): 106-112. ABSTRACT: Introduction:Peritoneal carcinomatosis is a condition that may be present in the natural history of colorectal cancer and some other tumors, such as pseudomyxoma peritonei. It has been associated with poor prognosis. The treatment for patients with this condition, up until recently, was systemic chemotherapy or palliative care to relieve the pain and suffering caused by peritoneal dissemination of certain cancers. Promising results, however, have been reported after the implementation of radical cytoreductive surgery followed by peroperative hyperthermic intraperitoneal chemotherapy. Objective: To evaluate the results of cytoreductive surgery and peroperative hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal carcinomatosis secondary to colorectal cancer and pseudomyxoma peritonei. Results: We retrospectively evaluated 24 patients from 2004 to 2011. Mean age was 51.31 years, and 54% were female. The primary diagnosis in 50.01% of the cases was pseudomyxoma peritonei, 41.66%, of colon cancer, and 8.33%, of mesothelioma. The overall complication rate was around 83%, two patients (8%) subsequently died between the 8 th and 30 th postoperative day. There was an association between the peritoneal carcinomatosis index (PCI) and operative time. The one-year survival rate in the group examined was 60% for colon cancer, and 78.5% for pseudomyxoma. Overall survival was 50% in three years. Conclusion: cytoreductive surgery combined with HIPEC is a treatment option for patients with peritoneal carcinomatosis of colorectal origin and pseudomyxoma. Despite the high rate of peroperative complications (83%), it was possible to achieve a superior survival rate in relation to conventional treatments reported in the literature.Keywords: colorectal cancer; drug therapy; pseudomyxoma peritonei; surgery; peritoneum. RESUMO: Introdução:A carcinomatose peritoneal é uma condição que pode estar presente na história natural do câncer colorretal e de algumas outras neoplasias, como o pseudomixoma peritoneal, sendo associada com um prognóstico desfavorável. O tratamento oferecido aos pacientes portadores dessa condição, até recentemente, era a quimioterapia sistêmica ou apenas os cuidados paliativos para aliviar a dor e o sofrimento causados pela disseminação peritoneal de determinadas neoplasias. Resultados promissores, no entanto, têm sido relatados após a implementação da cirurgia citorredutora radical, seguida da quimioterapia hipertérmica intraperitoneal per-operatória. Objetivo: Avaliar os resultados da cirurgia citorredutora e da quimioterapia intraperitoneal hipertérmica per-operatória (HIPEC) em pacientes portadores da carcinomatose peritoneal, secundária ao câncer colorretal e ao pseudomixoma peritoneal. Resultados: Foram avaliados, retrospectivamente, 24 pa...

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Cytoreductive surgery and perioperative intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colonic origin: outcomes after 7 years’ experience of a new centre for peritoneal surface malignancies

Abstract: Cytoreductive surgery combined with HIPEC is a feasible technique that might increase patient survival. It represents a potential cure for selected patients who have no other alternatives.

Cited by 25 publications

References 37 publications

Pharmacokinetic and Pharmacodynamic Analysis of Hyperthermic Intraperitoneal Oxaliplatin-Induced Neutropenia in Subjects with Peritoneal Carcinomatosis

Pharmacokinetic and Pharmacodynamic Analysis of Hyperthermic Intraperitoneal Oxaliplatin-Induced Neutropenia in Subjects with Peritoneal Carcinomatosis

Initial experience with hyperthermic intra peritoneal chemotherapy and cytoreductivesurgery

Multimodal treatment of peritoneal malignancies - results of the implantation in a tertiary hospital

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