Pleura and Peritoneum最新文献

{"title":"Multicenter dose-escalation Phase I trial of mitomycin C pressurized intraperitoneal aerosolized chemotherapy in combination with systemic chemotherapy for appendiceal and colorectal peritoneal metastases: rationale and design.","authors":"Mustafa Raoof,&nbsp;Kevin M Sullivan,&nbsp;Paul H Frankel,&nbsp;Marwan Fakih,&nbsp;Timothy W Synold,&nbsp;Dean Lim,&nbsp;Yanghee Woo,&nbsp;Isaac Benjamin Paz,&nbsp;Yuman Fong,&nbsp;Rebecca Meera Thomas,&nbsp;Sue Chang,&nbsp;Melissa Eng,&nbsp;Raechelle Tinsley,&nbsp;Richard L Whelan,&nbsp;Danielle Deperalta,&nbsp;Marc A Reymond,&nbsp;Jeremy Jones,&nbsp;Amit Merchea,&nbsp;Thanh H Dellinger","doi":"10.1515/pp-2022-0116","DOIUrl":"https://doi.org/10.1515/pp-2022-0116","url":null,"abstract":"<p><strong>Objectives: </strong>Peritoneal metastasis (PM) from appendiceal cancer or colorectal cancer (CRC) has significant morbidity and limited survival. Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is a minimally invasive approach to treat PM. We aim to conduct a dose-escalation trial of mitomycin C (MMC)-PIPAC combined with systemic chemotherapy (FOLFIRI) in patients with PM from appendiceal cancer or CRC.</p><p><strong>Methods: </strong>This is a multicenter Phase I study of MMC-PIPAC (NCT04329494). Inclusion criteria include treatment with at least 4 months of first- or second-line systemic chemotherapy with ineligibility for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Exclusion criteria are: progression on chemotherapy; extraperitoneal metastases; systemic chemotherapy intolerance; bowel obstruction; or poor performance status (ECOG>2). Escalating MMC-PIPAC doses (7-25 mg/m²) will be administered in combination with standard dose systemic FOLFIRI. Safety evaluation will be performed on 15 patients (dose escalation) and six expansion patients: 21 evaluable patients total.</p><p><strong>Results: </strong>The primary endpoints are recommended MMC dose and safety of MMC-PIPAC with FOLFIRI. Secondary endpoints are assessment of response (by peritoneal regression grade score; Response Evaluation Criteria in Solid Tumors [RECIST 1.1], and peritoneal carcinomatosis index), progression free survival, overall survival, technical failure rate, surgical complications, conversion to curative-intent CRS-HIPEC, patient-reported outcomes, and functional status. Longitudinal blood and tissue specimens will be collected for translational correlatives including pharmacokinetics, circulating biomarkers, immune profiling, and single-cell transcriptomics.</p><p><strong>Conclusions: </strong>This Phase I trial will establish the recommended dose of MMC-PIPAC in combination with FOLFIRI. Additionally, we expect to detect an early efficacy signal for further development of this therapeutic combination.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 4","pages":"169-177"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10275848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal regression grading score (PRGS) in peritoneal metastasis: how many biopsies should be examined?","authors":"Wiebke Solass,&nbsp;Christoph Meisner,&nbsp;Florian Kurtz,&nbsp;Giorgi Nadiradze,&nbsp;Marc A Reymond,&nbsp;Hans Bösmüller","doi":"10.1515/pp-2022-0118","DOIUrl":"https://doi.org/10.1515/pp-2022-0118","url":null,"abstract":"<p><strong>Objectives: </strong>The four-tied peritoneal regression grading score (PRGS) is increasingly used to evaluate the response of peritoneal metastases (PM) to chemotherapy. The minimal number of peritoneal biopsies needed for PRGS determination remains unclear.</p><p><strong>Methods: </strong>A prospective cohort of 89 PM patients treated with 210 pressurized intraperitoneal aerosol chemotherapy (PIPAC) cycles was investigated. Four biopsies from every abdominal quadrant were recommended. Histological tumor response was defined as a stable or decreasing mean PRGS between therapy cycles, progression increasing. We compared the diagnostic uncertainty induced by missing biopsies to the histological response.</p><p><strong>Results: </strong>A total of 49 patients had at least two PIPAC and were eligible for therapy response assessment. Mean PRGS decreased from 2.04 (CI 5-95% 1.85-2.27) to 1.79 (CI 5-95% 1.59-2.01), p=0.14, as a proof of therapy effectiveness. 35 (71.4%) patients had a stable or decreasing PRGS (therapy response), 14 (28.6%) a PRGS increase (disease progression). Histology showed agreement between four biopsies in 42/210 laparoscopies (20%), between ≥3 biopsies in 103 (49%), and between ≥2 biopsies in 169 laparoscopies (81%). Mean loss of information with one missing biopsy was 0.11 (95% CI=0.13) PRGS points, with two missing biopsies 0.18 (95% CI 0.21). In 9/49 patients (18.3%), the loss of information with one less biopsy exceeded the change in PRGS under therapy.</p><p><strong>Conclusions: </strong>A minimum of three biopsies is needed to diagnose PM progression with an accuracy superior to 80%. Missing biopsies often result in a false diagnosis of tumor progression.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 4","pages":"179-185"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10788489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal metastases of unknown primary with hepatoid features.","authors":"Lakhdar Khellaf,&nbsp;Stéphanie Nougaret,&nbsp;Sébastien Carrère,&nbsp;Frédéric Bibeau","doi":"10.1515/pp-2022-0113","DOIUrl":"https://doi.org/10.1515/pp-2022-0113","url":null,"abstract":"A 59-year-old woman presented with isolated peritoneal metastases in the context of elevated serum AFP levels (Figure 1A and B). No primary tumour was found, notably from the liver, the gastrointestinal or gynecological tracts. A laparoscopic assessment reported a peritoneal cancer index (PCI) reaching 22/39 and biopsies performed disclosed hepatocellular carcinoma (HCC). A chemotherapy followed by Figure 1: Magnetic resonance imaging (MRI) of the liver and peritoneum (axial T2 weighted images). (A) Initial MRI: ill-defined T2 hyperintense nodule within the falciform ligament of the liver (arrow). (B) MRI at 3 months: Appearance of several peritoneal metastases (arrows). Note the absence of any parenchymal liver tumour in both images. (C) Histopathological analysis: hepatocellular carcinoma (asterisks) in the falciform ligament of the liver, representing the starting point of the peritoneal disease. Ectopic liver is circled in red (greater axis: 15 mm), with detectable steatosis (HES, ×6). Note the independent vasculo-biliary stalk, highlighted in the inset (HES, ×50). HES: hematoxylin-eosin-saffron.","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"157-158"},"PeriodicalIF":1.8,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of prophylactic HIPEC in non-metastatic, serosa-invasive gastric cancer: a literature review.","authors":"Aditya R Kunte,&nbsp;Aamir M Parray,&nbsp;Manish S Bhandare,&nbsp;Sohan Lal Solanki","doi":"10.1515/pp-2022-0104","DOIUrl":"https://doi.org/10.1515/pp-2022-0104","url":null,"abstract":"<p><p>The role of prophylactic hyperthermic intraperitoneal chemotherapy (p-HIPEC) in serosa invasive gastric cancers without gross or microscopic peritoneal disease, to reduce the rate of peritoneal relapse is an area of ongoing research. Although p-HIPEC is effective in reducing the rate of peritoneal relapse and improving disease free and overall survival with or without adjuvant chemotherapy, when added to curative surgery in locally advanced, non-metastatic gastric cancers, the available literature is at best, heterogeneous, centre-specific and skewed. Apart from that, variations in the systemic therapy used, and the presence of the associated nodal disease further complicate this picture. To evaluate the role of p-HIPEC the PubMed, Cochrane central register of clinical trials, and the American Society of Clinical Oncology (ASCO) meeting library were searched with the search terms, \"gastric\", \"cancer\", \"hyperthermic\", \"intraperitoneal\", \"chemotherapy\", prophylactic\", \"HIPEC\" in various combinations, and a critical review of the available evidence was done. Although p-HIPEC is a promising therapy in the management of locally advanced gastric cancers, the current evidence is insufficient to recommend its inclusion into routine clinical practice. Future research should be directed towards identification of the appropriate patient subset and towards redefining its role with current peri-operative systemic therapies.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"103-115"},"PeriodicalIF":1.8,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in multimodal therapy for patients with oligometastatic peritoneal gastric cancer: a randomized multicenter phase III trial PIPAC VEROne.","authors":"Francesco Casella,&nbsp;Maria Bencivenga,&nbsp;Riccardo Rosati,&nbsp;Uberto Romario Fumagalli,&nbsp;Daniele Marrelli,&nbsp;Fabio Pacelli,&nbsp;Antonio Macrì,&nbsp;Annibale Donini,&nbsp;Lorena Torroni,&nbsp;Michele Pavarana,&nbsp;Giovanni De Manzoni","doi":"10.1515/pp-2022-0111","DOIUrl":"https://doi.org/10.1515/pp-2022-0111","url":null,"abstract":"<p><strong>Objectives: </strong>Peritoneal carcinomatosis is the most frequent site of metastases in patients with gastric cancer. Current standard treatment is palliative systemic chemotherapy with very poor prognosis. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) resulted in long-term benefits in selected patients. Among patients with peritoneal carcinomatosis, a distinctive subset is oligometastatic disease which is characterized by low metastatic burden. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a recent technique of intraperitoneal chemotherapy used in combination with systemic chemotherapy with promising results.</p><p><strong>Methods: </strong>PIPAC VER-One is a prospective, randomized, multicenter phase III clinical trial that aims to evaluate the effectiveness of the use of PIPAC in combination with systemic chemotherapy in patients with gastric cancer and synchronous positive peritoneal cytology and/or limited peritoneal metastases (peritoneal cancer index [PCI] ≤6). Patients will be randomized into two arms: arm A (control) treated with standard systemic chemotherapy and arm B (experimental) treated with a bidirectional scheme including PIPAC and systemic chemotherapy.</p><p><strong>Results: </strong>Primary endpoint is the secondary resectability rate. Secondary endpoints are: overall survival (OS), pregression-free survival (PFS), disease-free survival (DFS), histological response assessed both on primary tumor and peritoneal lesions, quality of life (QoL), complication rate (CTCAE v5), and incremental cost-effectiveness ratios (ICER).</p><p><strong>Conclusions: </strong>The role of PIPAC in multimodal treatment for oligometastatic gastric cancer will be investigated in this trial.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"135-141"},"PeriodicalIF":1.8,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal tissue concentrations and penetration of carboplatin in a HIPEC procedure ‒ assessment in a novel porcine model.","authors":"Elisabeth K Petersen,&nbsp;Mats Bue,&nbsp;Christina Harlev,&nbsp;Andrea R Jørgensen,&nbsp;Anne Schmedes,&nbsp;Pelle Hanberg,&nbsp;Lone K Petersen,&nbsp;Maiken Stilling","doi":"10.1515/pp-2022-0110","DOIUrl":"https://doi.org/10.1515/pp-2022-0110","url":null,"abstract":"<p><strong>Objectives: </strong>Peritoneal dissemination from intraabdominal cancers is associated with poor prognosis and rapid disease progression. Hyperthermic intraperitoneal chemotherapy (HIPEC) is an antineoplastic treatment, which has improved survival and recurrence-free survival, but little is known about the acquired chemotherapy concentrations in local tissues. The aim of this study was to assess concentrations of carboplatin during and after HIPEC treatment dynamically and simultaneously in various abdominal organ tissues by means of microdialysis in a novel porcine model.</p><p><strong>Methods: </strong>Eight pigs underwent imitation cytoreductive surgery followed by HIPEC (90 min) using a carboplatin dosage of 800 mg/m². Microdialysis catheters were placed for sampling of drug concentrations in various solid tissues: peritoneum, liver, bladder wall, mesentery and in different depths of one mm and four mm in the hepatoduodenal ligament and rectum. During and after HIPEC, dialysates and blood samples were collected over 8 h.</p><p><strong>Results: </strong>No statistically significant differences in mean AUC_0-last (range: 2,657-5,176 min·µg/mL), mean C_max (range: 10.6-26.0 µg/mL) and mean T_max (range: 105-206 min) were found between the compartments. In plasma there was a tendency towards lower measures. No difference between compartments was found for tissue penetration. At the last samples obtained (450 min) the mean carboplatin concentrations were 4.9-9.9 µg/mL across the investigated solid tissues.</p><p><strong>Conclusions: </strong>Equal carboplatin distribution in abdominal organ tissues, detectable concentrations for at least 6 h after HIPEC completion, and a carboplatin penetration depth of minimum four mm were found. The present study proposes a new HIPEC porcine model for future research.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"117-125"},"PeriodicalIF":1.8,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontmatter","authors":"","doi":"10.1515/pp-2022-frontmatter2","DOIUrl":"https://doi.org/10.1515/pp-2022-frontmatter2","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"25 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81486503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative anaesthetic management in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC): a retrospective analysis in a single tertiary care cancer centre.","authors":"Raghav Gupta,&nbsp;Nishkarsh Gupta,&nbsp;Prashant Sirohiya,&nbsp;Anuja Pandit,&nbsp;Brajesh Kumar Ratre,&nbsp;Saurabh Vig,&nbsp;Swati Bhan,&nbsp;Ram Singh,&nbsp;Balbir Kumar,&nbsp;Shweta Bhopale,&nbsp;Seema Mishra,&nbsp;Rakesh Garg,&nbsp;Sachidanand Jee Bharati,&nbsp;Vinod Kumar,&nbsp;Suryanarayana Deo,&nbsp;Sushma Bhatnagar","doi":"10.1515/pp-2022-0001","DOIUrl":"https://doi.org/10.1515/pp-2022-0001","url":null,"abstract":"<p><strong>Objectives: </strong>Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with increased morbidity and mortality. We retrospectively analysed the perioperative anesthetic management in patients undergoing HIPEC surgery.</p><p><strong>Methods: </strong>After ethics approval, we reviewed the records of patients who underwent CRS/HIPEC from 2015 until 2020. We noted the peritoneal carcinomatosis index (PCI), blood loss, anastomoses done, total amount of fluid given, delta temperature and duration of surgery. These were correlated with the need for postoperative ventilation, length of ICU stay, Clavien-Dindo score and 30 day mortality.</p><p><strong>Results: </strong>Of the 180 patients reviewed, the majority were women (85%) with a mean age of 48 years who had ovarian tumors (n=114). The total amount of fluid given was associated with an increased length of ICU stay (p=0.008). Prolonged surgery resulted in increased length of ICU stay (p<0.001), need for postoperative ventilation (p=0.006) and a poor Clavien-Dindo score (p=0.039). A high PCI score correlated with increased ICU stay, 30 day mortality (p<0.001), and the need for postoperative ventilation (0.005).</p><p><strong>Conclusions: </strong>PCI, duration of surgery and blood loss were major predictors of postoperative morbidity. Additionally, the amount of fluid given and delta temperature affected patient outcome and should be individualized to the patient's needs.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"127-134"},"PeriodicalIF":1.8,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of biopsy site selection for peritoneal regression grading score (PRGS) in peritoneal metastasis treated with repeated pressurized intraperitoneal aerosol chemotherapy (PIPAC).","authors":"Mojib Fallah,&nbsp;Sönke Detlefsen,&nbsp;Alan P Ainsworth,&nbsp;Claus W Fristrup,&nbsp;Michael B Mortensen,&nbsp;Per Pfeiffer,&nbsp;Line S Tarpgaard,&nbsp;Martin Graversen","doi":"10.1515/pp-2022-0108","DOIUrl":"https://doi.org/10.1515/pp-2022-0108","url":null,"abstract":"<p><strong>Objectives: </strong>The four-tiered peritoneal regression grading score (PRGS) is used for histological response evaluation in patients with peritoneal metastasis (PM) treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Four quadrant biopsies (QBs) from the parietal peritoneum should be assessed by PRGS, but consensus on biopsy site strategy for follow-up biopsies during repeated PIPACs is lacking. We aimed to evaluate whether there is a difference between PRGS in QBs from clips marked PM (QB-CM) compared to biopsies from PM with the visually most malignant features (worst biopsy, WB).</p><p><strong>Methods: </strong>Prospective, descriptive study. During the first PIPAC, index QBs sites were marked with metal clips. During the second PIPAC, an independent surgical oncologist selected biopsy site for WB and biopsies were taken from QB-CM and WB. One blinded pathologist evaluated all biopsies according to PRGS. From each biopsy, three step sections were stained H&E, followed by an immunostained section, and another three step sections stained H&E.</p><p><strong>Results: </strong>Thirty-four patients were included from March 2020 to May 2021. Median age 64 years. Maximum mean PRGS in QB-CM at PIPAC 1 was 3.3 (SD 1.2). Maximum mean PRGS in QB-CM at PIPAC 2 was 2.6 (SD 1.2), whereas mean PRGS in WB at PIPAC 2 was 2.4 (SD 1.3). At PIPAC 2, there was agreement between maximum PRGS from QB-CM and PRGS from WB in 21 patients. Maximum PRGS from QB-CM was higher in nine and lower in four patients, compared to PRGS from WB.</p><p><strong>Conclusions: </strong>Biopsies from QB-CM did not overestimate treatment response compared to biopsies from WB.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"143-148"},"PeriodicalIF":1.8,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of metastasis location on outcome after cytoreductive surgery and heated intraperitoneal chemotherapy.","authors":"Lise Hommelgaard,&nbsp;Jonas A Funder,&nbsp;Victor J Verwaal","doi":"10.1515/pp-2022-0106","DOIUrl":"https://doi.org/10.1515/pp-2022-0106","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate how metastases in the seven topographical regions of the simplified peritoneal cancer index (sPCI) affect the survival of patients treated with cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis (PC) from colorectal (CRC) or appendiceal cancers.</p><p><strong>Methods: </strong>Data was collected retrospectively from patient records. Abdominal regions affected by PC were identified using the histological verification of surgically removed tumours found in the electronic pathology report. Verified tumours were grouped according to the sPCI topography.</p><p><strong>Results: </strong>One hundred and eighty-three patients treated with CRS and HIPEC were included. Metastases in the small bowel had a negative impact on survival with a hazard ratio of 1.89 (p=0.005). A significantly impaired survival was also detected for patients affected by metastases in the ileocolic region (p=0.01) and in the omentum and spleen (p=0.04).</p><p><strong>Conclusions: </strong>When selecting patients for CRS and HIPEC a more cautious approach may be applied by considering the regions affected.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"7 3","pages":"149-155"},"PeriodicalIF":1.8,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}