Use of PlasmaJet for Peritoneal Carcinomatosis in Ovarian Cancer

Panuccio, Enrico; Leunen, Karin; Nieuwenhuysen, Els Van; Neven, Patrick; Lambrechts, Sandrina; Vergote, Ignace

doi:10.1097/igc.0000000000000788

Cited by 11 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The PlasmaJet Surgery Device is an advanced energy system delivering pure plasma to the tissues. Plasma is a highly energized phase of gas which is short-lived and quickly dissipates at the targeted site of application, allowing controlled use [12, 13].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of effectiveness of the PlasmaJet surgical device in the treatment of advanced stage ovarian cancer (PlaComOv-study): study protocol of a randomized controlled trial in the Netherlands

et al. 2019

View full text Add to dashboard Cite

BackgroundThe most important goal for survival benefit of advanced stage ovarian cancer is to surgically remove all visible tumour, because complete cytoreductive surgery (CCS) has been shown to be associated with prolonged survival.In a remarkable number of women, CCS is very challenging. Especially in women with many small metastases on the peritoneum and intestinal surface, conventional CCS with electrosurgery is not able to be “complete” in removing safely all visible tumour.In this randomized controlled trail (RCT) we investigate whether the use of the PlasmaJet Surgical Device increases the rate of CCS, and whether this indeed leads to a longer progression free and overall survival.The main research question is: does the use of the PlasmaJet Surgical Device in surgery for advanced stage ovarian cancer result in an increased number of complete cytoreductive surgeries when compared with conventional surgical techniques. Secondary study objectives are: 30-day morbidity, duration of surgery, blood loss, length of hospitalisation, Quality of Life, disease-free survival, overall survival, percentage colostomy, cost-effectiveness.MethodsThe study design is a multicentre single-blinded superiority RCT in two university and nine non-university hospitals in The Netherlands. Three hundred and thirty women undergoing cytoreductive surgery for advanced stage ovarian carcinoma (FIGO Stage IIIB-IV) will be randomized into two arms: use of the PlasmaJet (intervention group) versus the use of standard surgical instruments combined with electrocoagulation (control group). The primary outcome is the rate of complete cytoreductive surgery in both groups.Secondary study objectives are: 30-day morbidity, duration of surgery, blood loss, length of hospitalisation, Quality of Life, disease-free survival, overall survival, percentage colostomy, cost-effectiveness. Quality of life will be evaluated using validated questionnaires at baseline, at 1 and 6 months after surgery and at 1, 2, 3 and 4 years after surgery.DiscussionWe hypothesize the additional value of the use of the PlasmaJet in CCS for advanced stage epithelial ovarian cancer. More knowledge about efficacy, side effects, recurrence rates, cost effectiveness and pathology findings after using the PlasmaJet Device is advocated. This RCT may aid in this void.Trial registrationDutch Trial Register NTR6624. Registered 18 August 2017.Medical Ethical Committee approval number: NL62035.078.17 (Medical Ethical Committee Erasmus Medical Centre Rotterdam).

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of effectiveness of the PlasmaJet surgical device in the treatment of advanced stage ovarian cancer (PlaComOv-study): study protocol of a randomized controlled trial in the Netherlands

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The authors did not provide data on colostomies. Panuccio et al [8] included 19 patients undergoing primary/interval or secondary debulking for ovarian cancer FIGO stage IIIC-IV. Complete debulking was achieved in all 19 patients.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of the PlasmaJet® Device in advanced stage ovarian carcinoma: a systematic review

2019

View full text Add to dashboard Cite

About 80 % of all women affected by ovarian cancer present with advanced stage disease at the time of diagnosis. Achieving complete cytoreduction is complicated when many small tumor spots are found. Yet, complete cytoreduction is the most important determinant of survival. Application of a thermal plasma energy device to standard surgical instruments may help achieve complete cytoreduction. The ‘PlasmaJet® Device’ (Plasma Surgical, Inc., Roswell, GA, USA) is an electrically neutral device which emits a high–energy jet of argon plasma for direct tissue effects. We performed a literature review to investigate whether the use of the ‘PlasmaJet® Device’ in surgery of advanced stage ovarian carcinoma (FIGO IIIB-IV) is effective and safe. The primary outcome was the proportion of complete cytoreductions. The secondary outcomes were: complication rate, proportion of colostomies applied, histological findings, disease-free survival and overall survival. Five case series or reports were found, including a total of 77 patients with FIGO stage IIIC-IV ovarian cancer in whom the PlasmaJet® device was used for primary or interval debulking. Complete cytoreduction was obtained in 79% of the patients. Apart from one pneumothorax after extensive surgery, but no harm or additional complications related to the use of the PlasmaJet® Device were reported. Data on disease-free survival or overall survival were not reported. These findings suggest that the PlasmaJet® Device is an efficient and safe innovative surgical device for debulking surgery with encouraging results. We have proposed an RCT in which we will compare feasibility, safety and effectiveness aspects of the use of the PlasmaJet® versus conventional electrosurgery in advanced stage epithelial ovarian cancer (FIGO IIIB-IV).

show abstract

“…Panuccio et al reported a median operative time of 270 minutes (range = 100-420 minutes), while the median blood loss as reported by 2 of the included studies was 600 mL (range = 100-2500 mL). 12 In those studies, intra-and postoperative blood transfusion was required in a total of 5/23 and 3/23 patients, respectively, whereas median hospital stay was 6.5 days (range = 2-21 days). Incidence of intraoperative complications was 32% (8/25), but none of them was due to the application of PlasmaJet.…”

Section: Main Outcomesmentioning

confidence: 93%

“…Complete macroscopic resection was recorded for 59/70 (84.3%) women; data from 2 studies. 11,12 Additionally, 2 patients in the study by Renaud and Sebastianelli had residual disease from 5 to 10 mm, while lesions <5 mm remained in 3 of the recruited patients. 15 Postoperatively, 17 out of 72 patients (23.6%) developed complications that include pneumothorax due to diaphragmatic resection, systemic infections, or wound-related complications.…”

Section: Main Outcomesmentioning

confidence: 95%

“…9 A total of 5 studies (2 retrospective, 1 prospective, and 2 case reports) were considered eligible for inclusion in the present systematic review. [11][12][13][14][15] Data on 77 patients who were treated with application of neutral argon plasma (PlasmaJet) during cytoreductive surgery for advanced stage ovarian cancer with peritoneal spread were retrieved from the recruited studies. The analyzed indices were structured in 2 tables as follows: studies and patients characteristics (Table 1) and intra-and postoperative outcomes ( Table 2).…”

Section: Excluded and Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

The Emerging Role of Neutral Argon Plasma (PlasmaJet) in the Treatment of Advanced Stage Ovarian Cancer: A Systematic Review

2020

View full text Add to dashboard Cite

Objective. To evaluate the contribution of PlasmaJet application in achieving optimal cytoreduction in advanced ovarian cancer. Methods. We systematically searched for articles published up to June 2019 using MEDLINE, Scopus, Google Scholar databases and clinicaltrials.gov along with the references of the articles retrieved in full text. Observational studies and case reports addressing cases of women with peritoneal spread due to advanced stage ovarian cancer who were treated with application of PlasmaJet device were considered eligible for inclusion. Results. Three studies were excluded from further analysis when they were retrieved in full text. Five studies (2 retrospective, 1 prospective, and 2 case reports) that comprised 77 patients with age range from 38 to 85 years were included. Forty-three women underwent interval debulking surgery, 24 patients primary debulking surgery, and 6 had optimal debulking surgery, while in the remaining 4, a secondary debulking surgery was performed. Incidence of intraoperative complications was 32% (8/25), but none of them was due to the application of PlasmaJet. Complete macroscopic resection was achieved in 59 out of 70 (84.3%) women. Postoperatively, 17 out of 72 patients (23.6%) developed complications such as pneumothorax due to diaphragmatic resection, systemic infections, or wound-related complications. No postoperative mortality was recorded. Conclusions. Preliminary data on the use of PlasmaJet for ablation of ovarian cancer implants in the peritoneal cavity showed its safety and presented with promising outcomes in achieving complete cytoreduction.

show abstract

Use of PlasmaJet for Peritoneal Carcinomatosis in Ovarian Cancer

Abstract: In our series, the PlasmaJet seems to be an efficient device for tumor ablation or dissection to obtain complete resection of all macroscopic disease in patients with peritoneal carcinomatosis.

Cited by 11 publications

References 10 publications

Evaluation of effectiveness of the PlasmaJet surgical device in the treatment of advanced stage ovarian cancer (PlaComOv-study): study protocol of a randomized controlled trial in the Netherlands

Evaluation of effectiveness of the PlasmaJet surgical device in the treatment of advanced stage ovarian cancer (PlaComOv-study): study protocol of a randomized controlled trial in the Netherlands

Effectiveness and safety of the PlasmaJet® Device in advanced stage ovarian carcinoma: a systematic review

The Emerging Role of Neutral Argon Plasma (PlasmaJet) in the Treatment of Advanced Stage Ovarian Cancer: A Systematic Review

Contact Info

Product

Resources

About