Peritoneal Carcinomatosis in Colorectal Cancers – Management Perspective Needs a Change

Bhandare, Manish; Patil, Prachi; Pai, Vishwas D.; Bhamre, Rahul; Ostwal, Vikas; Saklani, Avanish

doi:10.1016/j.clcc.2016.08.001

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…The diagnosis of PC is an important prognostic factor and carries management implications in the setting of gastrointestinal and gynecological malignancies. [21][22][23][24][25][26][27] Therefore, this study sought to compare individual or combinations of SCI against PET/MRI to assess potential diagnostic improvements. Notably, FIGURE 1.…”

Section: Discussionmentioning

confidence: 99%

Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) Versus the Standard of Care Imaging in the Diagnosis of Peritoneal Carcinomatosis

Furtado

Ferrone

et al. 2022

Annals of Surgery

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Objective: To compare positron emission tomography (PET)/magnetic resonance imaging (MRI) to the standard of care imaging (SCI) for the diagnosis of peritoneal carcinomatosis (PC) in primary abdominopelvic malignancies. Summary Background Data: Identifying PC impacts prognosis and management of multiple cancer types. Methods: Adult subjects were prospectively and consecutively enrolled from April 2019 to January 2021. Inclusion criteria were: 1) acquisition of whole-body contrast-enhanced (CE) 18F-fluorodeoxyglucose PET/MRI, 2) pathologically confirmed primary abdominopelvic malignancies. Exclusion criteria were: 1) greater than 4 weeks interval between SCI and PET/MRI, 2) unavailable follow-up. SCI consisted of whole-body CE PET/computed tomography (CT) with diagnostic quality CT, and/or CE-CT of the abdomen and pelvis, and/or CE-MRI of the abdomen±pelvis. If available, pathology or surgical findings served as the reference standard, otherwise, imaging followup was used. When SCI and PET/MRI results disagreed, medical records were checked for management changes. Follow-up data were collected until August 2021. Results: One hundred sixty-four subjects were included, 85 (52%) were female, and the median age was 60 years (interquartile range 50–69). At a subject level, PET/MRI had higher sensitivity (0.97, 95% CI 0.86–1.00) than SCI (0.54, 95% CI 0.37–0.71), P < 0.001, without a difference in specificity, of 0.95 (95% CI 0.90–0.98) for PET/MRI and 0.98 (95% CI 0.93–1.00) for SCI, P ¼ 0.250. PET/MRI and SCI results disagreed in 19 cases. In 5/19 (26%) of the discordant cases, PET/MRI findings consistent with PC missed on SCI led to management changes. Conclusion: PET/MRI improves detection of PC compared with SCI which frequently changes management.

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Section: Discussionmentioning

confidence: 99%

Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) Versus the Standard of Care Imaging in the Diagnosis of Peritoneal Carcinomatosis

Furtado

Ferrone

et al. 2022

Annals of Surgery

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“…Luciferase-expressing HCT116-luc cells were suspended in PBS containing 500 μg/mL Matrigel (Corning BD Matrigel Basement Membrane Matrix,) and injected into the abdomen of each mouse in a total volume of 100 μL (2.5 × 10 6 cells).…”

Section: Methodsmentioning

confidence: 99%

“…4,5 Maximum cytoreductive surgery (CRS) to remove macroscopic tumors from the abdominal cavity, and then intraperitoneal chemotherapy to eradicate all residual microscopic diseases are currently the standard treatment for advanced CRC. 6–8…”

Section: Introductionmentioning

confidence: 99%

Hyperthermic intraperitoneal chemotherapy with recombinant mutant human TNF-α and raltitrexed in mice with colorectal-peritoneal carcinomatosis

Gong

Song

Wang

et al. 2020

Exp Biol Med (Maywood)

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Peritoneum is one of the most common metastatic sites of colorectal cancer (CRC). It has been reported that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) prolongs the lifespan of patients with peritoneal carcinomatosis of colorectal origin (CRC-PC), while the drugs used for HIPEC are limited. We investigated the application of recombinant mutant human tumor necrosis factor-α (rmhTNF) combined with raltitrexed in the HIPEC treatment in a mice model with CRC-PC. In vitro, we detected the cytotoxicity and apoptosis of human colorectal cancer cells by 3–(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay, Western blot, and TdT-mediated dUTP Nick End Labeling (TUNEL) assay. In vivo, we established xenograft models of CRC-PC and assessed the antitumor effect by in vivo imaging, peritoneal cancer index scoring, and TUNEL assay. The results showed that the combination of rmhTNF and raltitrexed under hyperthermia with a temperature of 42°C inhibited the growth of colorectal cancer cells significantly in vitro, and after HIPEC treatments with rmhTNF and raltitrexed, peritoneal tumor growth was prohibited in vivo. Our findings about the efficacy of rmhTNF and raltitrexed used for HIPEC to treat CRC-PC will provide experimental data and basis for their potential clinical application. Impact statement Colorectal peritoneal carcinomatosis exhibits poor prognosis and presents a treatment challenge. At present, the main treatment is surgery, supplemented by hyperthermic intraperitoneal chemotherapy (HIPEC), but the drugs used for HIPEC are limited. Our study found that the combination of recombinant mutant human TNF-α (rmhTNF) and raltitrexed (RTX) under hyperthermia with a temperature of 42°C had antitumor effect both in vitro and vivo. The findings will provide experimental data and basis for the potential clinical application of rmhTNF and RTX, which might offer patients a new choice of therapeutic drugs.

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“…The Indian HIPEC registry has received no funding from either the government or the industry in contrast to the RENAPE and Netherlands cancer registry that are government recognised and funded. A curative approach to PM is a relatively new concept in the country and it will be long before it becomes a priority on the agenda of national policy makers [16,17]. As the scope of the registry increases, dedicated personnel will be needed thereby increasing the annual expenditure.…”

Section: Operational Issuesmentioning

confidence: 99%

Treading the beaten path with old and new obstacles: a report from the Indian HIPEC registry

Bhatt

Mehta

Zaveri

et al. 2018

International Journal of Hyperthermia

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Background: The Indian HIPEC registry is a self-funded registry instituted by a group of Indian surgeons for patients with peritoneal metastases (PM) undergoing surgical treatment. This work was performed to Evaluate outcomes of cytoreductive surgery ± HIPEC in patients enrolled in the registry. Identify operational problems. Methods: A retrospective analysis of patients enrolled in the registry from March 2016 to September 2017 was performed. An online survey was performed to study the surgeons' attitudes and existing practices pertaining to the registry and identify operational problems. Results: During the study period, 332 patients were enrolled in 8 participating centres. The common indication was ovarian cancer for three centres and pseudomyxoma peritonei for three others. The median PCI ranged from 3 to 23. A CC-0/1 resection was obtained in 94.7%. There was no significant difference in the morbidity (p ¼ .25) and mortality (p ¼ .19) rates between different centres. There was a high rate of failure-to-rescue (19.3%) patients with complications and the survival in patients with colorectal PM was inferior. A lack of dedicated personnel for data collection and entry was the main reason for only 10/43 surgeons contributing data. The other problem was the lack of complete electronic medical record systems at all centres. Conclusions: These results validate existing practices and identify country-specific problems that need to be addressed. Despite operational problems, the registry is an invaluable tool for audit and research. It shows the feasibility of fruitful collaboration between surgeons in the absence of any regulatory body or funding for the project.

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Peritoneal Carcinomatosis in Colorectal Cancers – Management Perspective Needs a Change

Cited by 5 publications

References 23 publications

Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) Versus the Standard of Care Imaging in the Diagnosis of Peritoneal Carcinomatosis

Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) Versus the Standard of Care Imaging in the Diagnosis of Peritoneal Carcinomatosis

Hyperthermic intraperitoneal chemotherapy with recombinant mutant human TNF-α and raltitrexed in mice with colorectal-peritoneal carcinomatosis

Treading the beaten path with old and new obstacles: a report from the Indian HIPEC registry

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