Physicians’ awareness of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer carcinomatosis

Spiegle, Gillian; Schmocker, Selina; Huang, Harden; Victor, J. Charles; Law, Calvin; McCart, J. Andrea; Kennedy, Erin

doi:10.1503/cjs.003912

Cited by 16 publications

(10 citation statements)

References 11 publications

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“…However, our response rate of 36.2% is much higher that other similar international surveys in this field [12,13,46]. Furthermore, while most other surveys [12,13,47,48] have assessed clinician views and awareness on effectiveness and safety of CRS and HIPEC, our survey and a recent Swiss survey [46] served to evaluate how clinicians view and manage commonly encountered cases with peritoneal disease, as timely, appropriate and evidence based care in such cases translates to better clinical outcomes. While this survey covered the use of HIPEC, it failed to evaluate the role of other intraperitoneal chemotherapy modalities such as early postoperative intraperitoneal chemotherapy (EPIC) or pressurised aerosolised chemotherapy (PIPAC).…”

Section: Discussionmentioning

confidence: 88%

Perceptions in the management of colorectal peritoneal metastases: A bi-national survey of colorectal surgeons

Narasimhan

Warrier

Michael

et al. 2019

Pleura and Peritoneum

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BackgroundThere is great variability in the uptake of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of colorectal peritoneal metastases (CRPM) in Australia and New Zealand. This study aims to provide a snapshot of perceptions among colorectal surgeons in the management of CRPM.MethodsA structured ten-question online survey was sent to all colorectal surgeons, with three questions on clinical experience and demographics, one on health economics and six on hypothetical clinical scenarios. Scores were collated and reported based on Likert scales.ResultsEighty-one respondents (36.2%) completed the survey. Most surgeons (66.7%) strongly disagreed with offering CRS and HIPEC at all hospitals. The majority (87.7%) agreed that CRS and HIPEC offered a higher survival benefit than systemic chemotherapy in pseudomyxoma peritonei (PMP), and 69.1% in CRPM (comparators: 60.5% ovarian cancer, 14.8% gastric cancer). There were mixed strategies in managing low-volume, isolated peritoneal recurrences. The majority did not recommend second-look laparoscopy, but favoured operative management of Krukenberg tumours. In the presence of incidental peritoneal metastases, only 29.6% favoured biopsy only and referring the patient to a peritoneal disease centre.ConclusionsResponse rate was relatively low. In Australia and New Zealand, colorectal surgeons see a strong role for CRS and HIPEC in the management of PMP and CRPM. The role of “second look” surgery in high-risk cases is controversial and not supported. Krukenberg tumours are viewed as surgical disease. Regular updates and collaboration with peritoneal centres may help surgeons stay abreast with latest evidence in the field.

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Section: Discussionmentioning

confidence: 88%

Perceptions in the management of colorectal peritoneal metastases: A bi-national survey of colorectal surgeons

Narasimhan

Warrier

Michael

et al. 2019

Pleura and Peritoneum

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“…In this study, 70.50% of respondents in group A and 60.7% in group B reported colorectal cancer carcinomatosis (CRC-C) as an indication for CRS and HIPEC; however, only 46% of respondents correctly identified CRC-C as an indication for CRS and HIPEC in a previous study, leading to the development of a referral checklist that includes a list of indications and contraindications for CRS and HIPEC [ 16 ]. The development of a referral checklist may be effective to provide patients with optimal care, as up to 90.9% of respondents in group A and 91.7% in group B reported treating patients with GI cancers, though only 54.5% of respondents in group A and 51.2% in group B were exposed to a HIPEC center during residency or fellowship training and only 31.8% of respondents in group A and 41.7% in group B learned about CRS and HIPEC during their training programs.…”

Section: Discussionmentioning

confidence: 99%

The attitude and practice of general surgeons toward cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A cross-sectional study

Traiki

Alotaibi

Alnmry

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) mandate well-established HIPEC and oncology centers, which are not available in many medical institutions. This study assessed the knowledge, attitude, and practice toward CRS and HIPEC of general surgeons in Riyadh, Saudi Arabia. Patients and methods General surgeons (n = 266) from nine hospitals who treat patients with gastrointestinal cancer were surveyed. The responses of surgeons who work in HIPEC and academic centers (Group A) and surgeons working in tertiary and secondary hospitals (Group B) were compared. The survey response rate was 48.1% (128/266). Results Surgeons in group B treated significantly more patients with peritoneal carcinomatosis per year than surgeons in group A ( P = .001). Group B reported having a HIPEC specialist at their hospital, and 71.4% reported that the nearest HIPEC center was within 30 miles, compared to 4.5% of respondents in group A ( P = .001). Lack of access to a HIPEC specialist was reported by 15.5% of surgeons in group B and 0% of surgeons in group A ( P = .006). HIPEC as a possible therapeutic option for appendiceal cancer was cited by 60.7% of surgeons in group B compared to 84.1% of surgeons in group A ( P = .007) and as a therapeutic option for ovarian cancer by 52.4% of surgeons in group B and 81.8% of surgeons in group A ( P = .001). Conclusion New strategies are needed to improve the knowledge and implementation of the referral system for HIPEC among general surgeons. Our study was limited by a low response rate.

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“…Previous studies on the acceptance of PC therapies portrayed a substantial variation in opinions according to factors such as specialty, experience, implementation of multidisciplinary tumor boards and availability of expert centers ( 13 , 26 , 33 , 34 ), which could contribute to the underutilization of these treatments. Accordingly, we compared potential differences between specialists and according to years of expertise, activity sector as well as country.…”

Section: Discussionmentioning

confidence: 99%

Current Opinion and Practice on Peritoneal Carcinomatosis Management: The North African Perspective

Souadka¹,

Essangri²,

Makni

et al. 2022

Front. Surg.

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BackgroundThe status of peritoneal surface malignancy (PSM) management in North Africa is undetermined. The aim of this study was to assess and compare current practice and knowledge regarding PSM and examine satisfaction with available treatment options and need for alternative therapies in North Africa.MethodsThis is a qualitative study involving specialists participating in PSM management in North Africa. The survey analyzed demographic characteristics and current knowledge and opinions regarding PSM management in different institutions. We also looked at goals and priorities, satisfaction with treatment modalities and heated intraperitoneal chemotherapy (HIPEC) usefulness according to specialty, country, years of experience, and activity sector.ResultsOne-hundred and three participants responded to the survey (response rate of 57%), including oncologists and surgeons. 59.2% of respondents had more than 10 years experience and 45.6% treated 20–50 PSM cases annually. Participants satisfaction with PSM treatment modalities was mild for gastric cancer (3/10 [IQR 2–3]) and moderate for colorectal (5/10 [IQR 3–5]), ovarian (5/10 [IQR 3–5]), and pseudomyxoma peritonei (5/10 [IQR 3–5]) type of malignancies. Good quality of life and symptom relief were rated as main priorities for treatment and the need for new treatment modalities was rated 9/10 [IQR 8–9]. The perceived usefulness of systemic chemotherapy in first intention was described as high by 42.7 and 39.8% of respondents for PSM of colorectal and gastric origins, while HIPEC was described as highly useful for ovarian (49.5%) and PMP (73.8) malignancies.ConclusionsThe management of PSM in the North African region has distinct differences in knowledge, treatments availability and priorities. Disparities are also noted according to specialty, country, years of expertise, and activity sector. The creation of referral structures and PSM networks could be a step forward to standardized PSM management in the region.

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Physicians’ awareness of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer carcinomatosis

Cited by 16 publications

References 11 publications

Perceptions in the management of colorectal peritoneal metastases: A bi-national survey of colorectal surgeons

Perceptions in the management of colorectal peritoneal metastases: A bi-national survey of colorectal surgeons

The attitude and practice of general surgeons toward cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A cross-sectional study

Current Opinion and Practice on Peritoneal Carcinomatosis Management: The North African Perspective

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