Preliminary Experience and Morbidity Analysis of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS/H IPEC ) from a Tertiary Cancer Center in India

Padmanabhan, Naveen; Kumar, Barath Raj; Pookunju, Ansar Pullampara; Srinivasan, Ayyapan; Mahajan, Vandana

doi:10.7860/jcdr/2015/14216.6075

Cited by 7 publications

(8 citation statements)

References 28 publications

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“…The median time to disease progression was around 13 months, which is consistent with previous literature. There have been speculations about the high concentration of hyperthermic drugs in the abdominal cavity facilitated the absorption by the peritoneum and the circulatory system through the portal vein and retroperitoneal lymphatic system, which is very consistent with route of GC metastasis, therefore controlling micro-metastases in the lymphatic system and liver [38]. However, more concrete evidence is required to sustain this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic HIPEC with radical D2 gastrectomy improves survival and peritoneal recurrence rates for locally advanced gastric cancer: personal experience from a randomized case control study

Beeharry

Zhu

et al. 2019

BMC Cancer

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Background To investigate the implications of prophylactic intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with D2 radical gastrectomy for locally advanced Gastric Cancer (AGC) in a randomized case control study. Method Eighty consecutive patients with locally AGC were randomly separated into 2 groups: HIPEC group (Curative Resection + intraoperative HIPEC with cisplatin 50 mg/m2 at 42.0 ± 1.0 °C for 60 min) and Control group (Curative Resection only). Intraoperative and post-operative events, clinical recovery, morbidity and the disease-free survival (DFS) rates were closely monitored. Results Faster recovery of bowel function (43 ± 5 h vs 68 ± 7, P < 0.05) and shorter postoperative stay (8d vs 14d, P < 0.05) were noted in the HIPEC group. Among the 40 HIPEC group patients, the highest intracranial temperature recorded during the procedure was 38.2 °C but the patient made an eventless recovery. Mild renal dysfunction, hyperbilirubinemia and mild liver dysfunction were recorded in the HIPEC group but their incidences were found to be statistically insignificant when compared with the control group (P > 0.05). The 3 year DFS rate analysis showed that the prophylactic HIPEC group had a higher DFS rate (93% vs 65%, P = 0.0054). The peritoneal recurrence rate was lower in the HIPEC group (3% vs 23%, P < 0.05). Conclusion Prophylactic HIPEC with radical D2 Gastrectomy improves survival and peritoneal recurrence rates for AGC with favorable post-operative recovery at low and acceptable morbidity.

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Section: Discussionmentioning

confidence: 99%

Prophylactic HIPEC with radical D2 gastrectomy improves survival and peritoneal recurrence rates for locally advanced gastric cancer: personal experience from a randomized case control study

Beeharry

Zhu

et al. 2019

BMC Cancer

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“…Padmanabhan et al found difficulties maintaining the intra-abdominal temperature with the Coliseum technique, which is why they then used the closed technique in the other cases. They based this on the fact that one of the great advantages of the closed technique is the minimal exposure of operating room personnel to the chemotherapeutic agent as well as the better maintenance of the intra-abdominal temperature [ 4 , 15 – 19 ]. Our findings agree with those seen by Padmanabhan et al However, the beneficial effect of the high intra-abdominal pressure that can theoretically be achieved with the closed technique may be offset by the existence of preferential circuits with under-treated areas of the abdominal cavity during HIPEC [ 4 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Are there intra-operative hemodynamic differences between the Coliseum and closed HIPEC techniques in the treatment of peritoneal metastasis? A retrospective cohort study

et al. 2017

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BackgroundAlthough two main methods of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) are currently accepted, the superiority of one over the other has not yet been demonstrated. The purpose of this study was to determine whether there are hemodynamic and temperature differences between patients who received HIPEC in two different techniques, open versus closed abdomen.MethodsThis retrospective study was conducted in our center between 2011–2015 in 30 patients who underwent surgery for peritoneal carcinomatosis secondary to colorectal cancer, in whom cytoreduction and HIPEC were performed by the Coliseum (15) or closed techniques (15). The main end points were morbidity, mortality, hemodynamic changes, and abdominal temperature. The comparative analysis of quantitative variables at different times was done with the parametric repeated measure ANOVA for those variables that fulfilled the suppositions of normality and independence and the Friedman non-parametric test for the variables that did not fulfill either of these suppositions.ResultsThere were no deaths in either group. The incidence of postoperative complications in the Coliseum group was 53% (8 patients), grade II–III. The incidence of complications in the closed group was 13% (2 patients), grade II–III. The intra-operative conditions regarding the systolic and diastolic pressures were more stable using the closed abdomen technique (but not significantly so). We found statistically significant differences in abdominal temperature in favor of the closed technique (p = 0.009).ConclusionsBoth HIPEC procedures are similar. In our series, the closed technique resulted in a more stable intra-abdominal temperature.

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“…К сожалению, исследование проводили целых 9 лет, и в течение этого времени стандарты для применения СА125 [22][23]26] и лечения рецидивирующего заболевания подверглись значительным изменениям [6]. С технической точки зрения, исследуемые группы не были стратифицированы в зависимости от выполнения циторедуктивной операции -одного из важнейших прогностических факторов.…”

Section: казанский медицинский журнал 2016 г том 97 №3unclassified

“…Внутрибрюшная терапия неудобна в проведении и часто плохо переносится, но современные данные свидетельствуют о том, что мы должны обеспечивать доступ к внутрибрюшной химиотерапии для большего количества людей с оптимальной циторедукцией. В будущем геномный анализ первичных раковых препаратов поможет выявить больных, которым внутрибрюшная терапия принесет максимальную пользу [26].…”

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Personalized approach to the ovarian cancer treatment

Savinova¹,

Гатауллин

2016

Kazan Med J

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The aim of the review is to summarize the modern views on etiopathogenesis and treatment of ovarian cancer, as well as to search for ways for a more personalized approach to the management of patients with this oncological disease. Despite the limited number of patients participating in clinical trials of ovarian cancer, there are obvious results of gradual evolution in its diagnosis and treatment. Studies of etiopathogenesis led to a better understanding of the ovarian cancer genesis mechanisms, whereas evolution in treatment was marked by combination of secondary cytoreductive surgery with the most effective chemotherapeutic drugs and biological agents. The introduction of biomarkers, particularly CA125 (cancer antigen 125), in the diagnostic algorithm for both primary and recurrent ovarian cancer has opened up new horizons for the application of effective methods of treatment at the disease earliest stages. However, in the landmark study of G.J. Rustin et al. there was no a statistically significant difference in disease-free and overall survival among female patients with immediate treatment of recurrent ovarian cancer based only on elevated CA125 and female patients in whom chemotherapy was initiated after the clinical symptoms manifestation. Conducting clinical trials in small cohorts of patients with certain ovarian cancer histotype will help to select one or another effective combination of chemotherapy and/or biological agents administered not only intravenously, but also intraperitoneally, and thereby provide the personalized approach to the treatment of this disease.

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Preliminary Experience and Morbidity Analysis of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS/H IPEC ) from a Tertiary Cancer Center in India

Cited by 7 publications

References 28 publications

Prophylactic HIPEC with radical D2 gastrectomy improves survival and peritoneal recurrence rates for locally advanced gastric cancer: personal experience from a randomized case control study

Prophylactic HIPEC with radical D2 gastrectomy improves survival and peritoneal recurrence rates for locally advanced gastric cancer: personal experience from a randomized case control study

Are there intra-operative hemodynamic differences between the Coliseum and closed HIPEC techniques in the treatment of peritoneal metastasis? A retrospective cohort study

Personalized approach to the ovarian cancer treatment

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