Multi-institutional study of peritoneal sarcomatosis from uterine sarcoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Sardi, Armando; Sipok, Arkadii; Baratti, Dario; Deraco, Marcello; Sugarbaker, Paul H.; Salti, George I.; Yonemura, Yutaka; Sammartino, Paolo; Gléhen, Olivier; Bakrin, Naoual; Díaz-Montes, Teresa; Gushchin, Vadim

doi:10.1016/j.ejso.2017.08.011

Cited by 20 publications

(14 citation statements)

References 34 publications

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“…37 Although the use of CRS/HIPEC in peritoneal sarcomatosis is controversial, it is considered an important treatment option in multiple centers worldwide. 19 46 Our study suggests that CRS/HIPEC offers a survival advantage in recurrent US without extra-abdominal metastasis. The median OS for our patients undergoing CRS/ HIPEC for recurrent US was 43.8 months (and 3-year OS of 71.4%), compared with 35.9 months (and 3-year OS of 40%) for the conventional surgery group.…”

Section: Discussionmentioning

confidence: 75%

“…Previous studies reported survival outcomes of patients with primary or recurrent US undergoing CRS only, CRS/HIPEC, or systemic chemotherapy; however, comparisons were not made among the different treatment groups. 18,20,44,46,48,49 Because this is a retrospective review based on a small number of cases and from a single institution, it is difficult to derive strong conclusions. Although statistical significance was not achieved, the results suggest that CRS/HIPEC offers a survival advantage in terms of both DFS and OS in recurrent US limited to the abdominal cavity.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in the Treatment of Recurrent Uterine Sarcoma

Díaz-Montes

El-Sharkawy

Lynam

et al. 2018

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Efficacy of Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in the Treatment of Recurrent Uterine Sarcoma

Díaz-Montes

El-Sharkawy

Lynam

et al. 2018

International Journal of Gynecological Cancer

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“…Moreover, in order to maximize the benefits of debulking surgery in cases presenting advanced stage uterine sarcomas with peritoneal involvement, certain authors proposed treatment with hyperthermic intraperitoneal chemotherapy with promising results. Therefore, in the study conducted by surgery in association with intraperitoneal chemotherapy might improve long-term outcomes especially in cases with uterine leiomyosarcoma; unfortunately the types of associated visceral resections were not detailed, therefore, there are no data regarding the necessity of association of urinary tract resections (20).…”

Section: Discussionmentioning

confidence: 99%

Urinary Tract Resections as Part of Debulking Surgery for Locally Advanced Endometrial Stromal Sarcomas

Bacalbaşa

Bălescu

Iliescu

et al. 2020

In Vivo

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Background/aim: Although very rare tumors, uterine sarcomas are extremely aggressive gynecologic malignancies being responsible for a significant number of gynecological cancer-related deaths. However, in such cases, it seems that cytoreductive surgery might increase the lifespan if debulking to no residual disease is achieved. Patients and Methods: We present a case series of three patients diagnosed with endometrial stromal sarcomas in which urinary tract resections were needed in order to maximize the debulking effort. Results: In all cases total hysterectomy with bilateral adnexectomy was performed; in the meantime, urinary tract resection was needed due to the local extension of the neoplastic disease and consisted of unilateral ureteral resection followed by reimplantation through ureteroneocystostomy in one case, bilateral ureteral resection en bloc with partial cystectomy and ureteral reimplantation in one case and total cystectomy with bilateral ureterectomy followed by cutaneous ostomy in the third case. Moreover, one case also necessitated rectosigmoidian resection followed by colorectal anastomosis. In all cases no residual disease was encountered at the end of the debulking surgery.Conclusion: Urinary tract resections might be needed in order to maximize the debulking effort in patients presenting endometrial stromal sarcomas. 793

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“…The studies of HIPEC in uterine sarcomatosis are summarized in Table 2 4,25–33 . Cisplatin (CDDP) has been used for many cases even with uterine sarcomatosis as the chemotherapeutic agent of HIPEC because CDDP is one of the most effective and proven chemotherapeutic agents for HIPEC for carcinomatous peritonitis, as we have already mentioned.…”

Section: Current Clinical Researchmentioning

confidence: 99%

“…Moreover, the addition of HIPEC has been shown to result in a significant improvement in overall survival (OS) of ovarian cancer patients in a meta‐analysis including two phase 3 trials and 11 observational studies in 2019 3 . Growing evidence of the efficacy of cytoreductive surgery with HIPEC has also been reported in uterine sarcoma with peritoneal sarcomatosis in a multi‐institutional study 4 . Therefore, HIPEC could be one of the new therapeutic strategies in such disseminated peritoneal lesions.…”

Section: Introductionmentioning

confidence: 99%

Hyperthermic intraperitoneal chemotherapy (HIPEC) for gynecological cancer

Tsuyoshi

Inoue

Kurokawa

et al. 2020

J of Obstet and Gynaecol

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Aim Hyperthermic intraperitoneal chemotherapy (HIPEC) is a method of administering anticancer agents directly while heating the abdominal cavity. The aim of this review is to know the current position of HIPEC in ovarian cancer and uterine sarcoma and its future prospects. Methods This article reviews the current literature and evidence for the clinical trial of HIPEC in ovarian cancer and uterine sarcoma with consideration of the cases treated in our department. Results In January 2018, van Driel et al. reported the results of their phase 3, randomized, controlled trial and the usefulness of neoadjuvant chemotherapy followed by interval debulking surgery. With respect to greater than grade 3 complications, such as suture failure, intestinal perforation, postoperative bleeding, wound issues and death, there were no significant differences between the HIPEC group and the no‐HIPEC group. In a meta‐analysis including two randomized, controlled studies and 11 observational studies in 2019, the addition of HIPEC to cytoreductive surgery significantly improved overall survival of ovarian cancer patients. Moreover, growing evidence of the efficacy of cytoreductive surgery with HIPEC has also been reported in uterine sarcoma with peritoneal sarcomatosis in a multi‐institutional study. HIPEC could be one of the new therapeutic strategies for such disseminated peritoneal lesions. Conclusion Since the usage regimen and temperature setting of HIPEC are not standardized, and its effectiveness and adverse events are greatly affected by the time of administration, it is necessary to consider clinical trials for the optimization and establishment of HIPEC in Japan in the future.

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Multi-institutional study of peritoneal sarcomatosis from uterine sarcoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Cited by 20 publications

References 34 publications

Efficacy of Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in the Treatment of Recurrent Uterine Sarcoma

Efficacy of Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in the Treatment of Recurrent Uterine Sarcoma

Urinary Tract Resections as Part of Debulking Surgery for Locally Advanced Endometrial Stromal Sarcomas

Hyperthermic intraperitoneal chemotherapy (HIPEC) for gynecological cancer

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