European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology最新文献

{"title":"Impact of signet ring cells on overall survival in peritoneal disseminated appendix cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.","authors":"Raphael Shamavonian,&nbsp;Joshua D Lansom,&nbsp;Josh B Karpes,&nbsp;Nayef A Alzahrani,&nbsp;David L Morris","doi":"10.1016/j.ejso.2020.11.134","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.11.134","url":null,"abstract":"<p><strong>Introduction: </strong>To determine the effect of signet ring cell (SRC) histopathology in appendix cancer with peritoneal dissemination on overall survival (OS) in patients undergoing cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC).</p><p><strong>Materials and methods: </strong>Retrospective cohort study from a prospectively maintained database of patients that underwent CRS/HIPEC for appendix cancer from April 1999 to December 2019.</p><p><strong>Results: </strong>255 patients were identified. 174 had high-grade disease with no SRC component, 35 with a low count of SRC and 46 with a high count of SRC. Median OS without SRC was 93.8 months vs 58.2 months for low count SRC and 23.7 months for high count SRC (P < 0.001). 5-year OS was 60% for patients with no SRC, 35.5% and 10% in those with low count and high count SRC respectively. On multivariate analysis, presence of SRC and complete cytoreduction score were identified as independent factors that affect OS.</p><p><strong>Conclusion: </strong>The presence of SRC in appendix cancer with peritoneal dissemination is associated with worse OS when compared to an absence of SRC in patients undergoing CRS/HIPEC.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"194-198"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.11.134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38682460","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":"Diagnostic and therapeutic algorithm for colorectal peritoneal metastases. A consensus of the peritoneal surface malignancies onco-team of the Italian society of surgical oncology.","authors":"Antonio Sommariva,&nbsp;Luca Ansaloni,&nbsp;Gian Luca Baiocchi,&nbsp;Stefano Cascinu,&nbsp;Roberto Cirocchi,&nbsp;Federico Coccolini,&nbsp;Marcello Deraco,&nbsp;Gianmaria Fiorentini,&nbsp;Roberta Gelmini,&nbsp;Andrea Di Giorgio,&nbsp;Piero Vincenzo Lippolis,&nbsp;Enrico Maria Pasqual,&nbsp;Cinzia Sassaroli,&nbsp;Antonio Macrì,&nbsp;Paolo Sammartino,&nbsp;Stefano Scaringi,&nbsp;Mario Valle,&nbsp;Marco Vaira","doi":"10.1016/j.ejso.2020.09.035","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.09.035","url":null,"abstract":"<p><strong>Aim: </strong>the surgical workup for colorectal cancer peritoneal metastases (CRCPM) is complex and should be managed in specialized centers. Diagnostic and therapeutic algorithms (DTA) have been proposed to balance optimal patients management and correct use of resources. Aim of this study was to establish a consensus on DTA for CRCPM patients in Italy.</p><p><strong>Method: </strong>a panel of 18 delegated members of centers afferent to Peritoneal Surface Malignancies Onco-team of the Italian Society of Surgical Oncology was established. A list of statements regarding the DTA of patients with CRCPM was prepared according to different activities and decision-making nodes with a defined entry and exit point. Consensus was obtained through RAND UCLA methodology.</p><p><strong>Results: </strong>two different DTA were defined and approved according to the modality of presentation of CRCPM (synchronous and metachronous). A consensus was also obtained on 17 of the 19 statements related to DTA.</p><p><strong>Conclusion: </strong>a shared model of DTA is now available for healthcare providers to monitor appropriateness in diagnosis and treatment of patients with isolated peritoneal metastases from CRC.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"164-171"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.09.035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38465202","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":"Long-term outcomes for patients with peritoneal acellular mucinosis secondary to low grade appendiceal mucinous neoplasms.","authors":"T Evans,&nbsp;O Aziz,&nbsp;B Chakrabarty,&nbsp;M S Wilson,&nbsp;L Malcomson,&nbsp;C Lavelle,&nbsp;S T O'Dwyer","doi":"10.1016/j.ejso.2020.10.020","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.10.020","url":null,"abstract":"<p><strong>Introduction: </strong>Low grade appendiceal mucinous neoplasms (LAMN) are known to metastasise to the peritoneum resulting in pseudomyxoma peritonei (PMP). Literature suggests that the long-term outcome is dependent on the cellular grade of the peritoneal histology, less is known about the risk to patients with acellular mucinosis (AM) alone. This study aims to review long-term outcomes in patients with PMP treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC), whose peritoneal histology was AM secondary to LAMN.</p><p><strong>Methods: </strong>Pathological and treatment outcomes were collected from a prospectively maintained database between 2005 and 2019. Data was collected on patients with LAMN and AM diagnosed following CRS/HIPEC. A single institution performed the surgery and pathology reporting, samples reported by three different pathologists.</p><p><strong>Results: </strong>Of the 2079 patients with any appendiceal neoplasm referred between 2005 and 2019, 809 underwent CRS/HIPEC, 67 (8%) of those had PMP with purely AM secondary to a LAMN. In the AM group the median age was 59, 37 (55%) were female, follow up was for a median 39 (2-145) months. Inpatient mortality occurred in 1 patient (1.5%), disease specific mortality in 2 (3%), recurrence in 2 (3%) and disease progression in 1 (1.5%).</p><p><strong>Conclusion: </strong>This study has identified AM secondary to LAMN as a low risk group for recurrence following CRS/HIPEC compared with epithelial pathology. Given such a low rate of recurrence we would recommend low intensity surveillance post CRS/HIPEC. Agreed standardised pathological assessment is required to exclude cellular material in specimens and diagnose AM.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"188-193"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.10.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38518704","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":"Current practice of pressurized intraperitoneal aerosol chemotherapy (PIPAC): Still standardized or on the verge of diversification?","authors":"Olivia Sgarbura,&nbsp;Laurent Villeneuve,&nbsp;Mohammad Alyami,&nbsp;Naoual Bakrin,&nbsp;Juan José Torrent,&nbsp;Clarisse Eveno,&nbsp;Martin Hübner","doi":"10.1016/j.ejso.2020.08.020","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.08.020","url":null,"abstract":"<p><strong>Background: </strong>PIPAC is a new treatment modality for peritoneal cancer which has been practiced and evaluated until very recently by few academic centers in a highly standardized manner. Encouraging oncological outcomes and the safety profile have led to widespread adoption. The aim of this study was to assess current PIPAC practice in terms of technique, treatment and safety protocol, and indications.</p><p><strong>Methods: </strong>A standardized survey with 82 closed-ended questions was sent online to active PIPAC centers which were identified by help of PIPAC training centers and the regional distributors of the PIPAC-specific nebulizer. The survey inquired about center demographics (n = 8), technique (n = 34), treatment and safety protocol (n = 34), and indications (n = 6).</p><p><strong>Results: </strong>Overall, 62 out of 66 contacted PIPAC centers answered the survey (response rate 93%). 27 centers had performed >60 PIPAC procedures. A consensus higher than 70% was reached for 37 items (50%), and higher than 80% for 28 items (37.8%). The topics with the highest degree of consensus were safety and installation issues (93.5% and 80.65%) while chemotherapy and response evaluation were the least consensual topics (63.7 and 59.6%). The attitudes were not influenced by volume, PIPAC starting year, type of activity, or presence of peritoneal metastases program.</p><p><strong>Conclusion: </strong>Homogeneous treatment standards of new techniques are important to guarantee safe implementation and practice but also to allow comparison between cohorts and multi-center analysis of merged data including registries. Efforts to avoid diversification of PIPAC practice include regular update of the PIPAC training curriculum, targeted research and a consensus statement.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"149-156"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.08.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38453654","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":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with or without early post-operative intraperitoneal chemotherapy for appendix neoplasms with peritoneal metastases: A propensity score analysis.","authors":"Mikael L Soucisse,&nbsp;Oliver Fisher,&nbsp;Winston Liauw,&nbsp;Lana Ghanipour,&nbsp;Peter Cashin","doi":"10.1016/j.ejso.2020.08.026","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.08.026","url":null,"abstract":"<p><strong>Introduction: </strong>- Early post-operative intraperitoneal chemotherapy (EPIC) can be used after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with resectable peritoneal metastases (PM). Whether EPIC adds any benefit is debatable.</p><p><strong>Methods: </strong>- We performed a retrospective case-control analysis of patients with PM of appendiceal origin treated by CRS + HIPEC ± EPIC at Uppsala University Hospital between 2004 and 2012. The 206 patients were divided into two groups depending on if they received EPIC or not. The two groups were propensity-matched with a 1:1 ratio. The patients in the EPIC group were mostly operated in the first three years of the unit's experience.</p><p><strong>Results: </strong>- After matching, 76 patients were left in each group. The groups were similar, except for the proportion of histological subtypes (p = 0.021) and chemotherapy agents used for HIPEC (0.017). Survival outcomes were stratified by histology. The patients who received EPIC had a longer hospital and ICU length of stay (15.71 vs 14.28 days, p = 0.049), (1.45 vs 1.05 days, p = 0.002), respectively. Post-operative complications were similar in both groups. Overall Survival (OS) and recurrence-free survival (RFS) did not differ for the patients with low-grade histology. The patients with high-grade tumors who received EPIC had a significantly worse OS (p = 0.0088) while having the same RFS as the patients who did not receive EPIC.</p><p><strong>Conclusion: </strong>Our results suggest there is no benefit of EPIC in patients with advanced appendiceal tumors while increasing hospital and ICU length of stays. A suboptimal group matching might influence our results.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"157-163"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.08.026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38488479","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":"Long term survival in patients with peritoneal metastasised gastric cancer treated with cytoreductive surgery and HIPEC: A multi-institutional cohort from PSOGI.","authors":"Andreas Brandl,&nbsp;Yutaka Yonemura,&nbsp;Olivier Glehen,&nbsp;Paul Sugarbaker,&nbsp;Beate Rau","doi":"10.1016/j.ejso.2020.10.006","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.10.006","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal metastasis (PM) of gastric cancer (GC) is relatively common (17%) and is associated with poor survival. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is still controversially discussed, as it has proven an increase in survival in selected patients, but only a small subgroup reached long-term survival. The aim of this study was to collect and analyse a worldwide cohort of patients treated with CRS and HIPEC with long-term survival in order to explore relevant patient characteristics.</p><p><strong>Methods: </strong>We conducted a questionnaire, which was distributed to all collaborators of the Peritoneal Surface Oncology Group International (PSOGI). Inclusion criteria were: histopathologic proven PM of GC, treated with CRS and HIPEC, and overall survival >5 years. Patient, tumour, and therapeutic details were collected and analysed.</p><p><strong>Results: </strong>From an analysis of 448 patients treated between 1994 and 2014, a total of 28 patients with a mean age of 53.0 years and mean PCI of 3.3 were included. The overall median survival was 11.0 years (min 5.0; max 27.9). The predictors completeness of cytoreduction (CC-0) and PCI<6 were present in 22/28 patients. 12/28 patients developed at a median of 9.6 years tumour recurrence, and was associated with inferior median overall survival compared to patients without recurrence (8.8 years vs. not reached; p = 0.002).</p><p><strong>Conclusions: </strong>Long-term survival and even cure are possible in patients with PM of GC treated with CRS and HIPEC. Completeness of cytoreduction and low PCI seemed to be crucial. Further studies are needed in order to improve existing selection criteria.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"172-180"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38506403","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":"Distribution of residual disease in the peritoneum following neoadjuvant chemotherapy in advanced epithelial ovarian cancer and its potential therapeutic implications.","authors":"Aditi Bhatt,&nbsp;Naoual Bakrin,&nbsp;Praveen Kammar,&nbsp;Sanket Mehta,&nbsp;Snita Sinukumar,&nbsp;Loma Parikh,&nbsp;Sakina Shaikh,&nbsp;Suniti Mishra,&nbsp;Mrinal Mallaya,&nbsp;Vahan Kepenekian,&nbsp;Nazim Benzerdjeb,&nbsp;Olivier Glehen","doi":"10.1016/j.ejso.2020.10.012","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.10.012","url":null,"abstract":"<p><strong>Introduction: </strong>Residual disease in 'normal appearing' peritoneum is seen in nearly 30% of the patients following neoadjuvant chemotherapy (NACT) for advanced ovarian cancer. The goal was to study the sequence of response in different regions, the commonest sites of occult residual disease, its incidence in different peritoneal regions and the potential therapeutic implications of these.</p><p><strong>Methods: </strong>This was a prospective multi-centre study (July 2018-June 2019). Pathological evaluation of cytoreductive surgery specimens was performed according to a fixed protocol. Prevalence of residual disease in different regions was used to study patterns of response and distribution of residual disease.</p><p><strong>Result: </strong>In 85 patients treated between July 2018 to June 2019, microscopic disease in 'normal appearing' peritoneal regions was seen in 22 (25.2%) and in normal peritoneum around tumor nodules in 30 (35.2%) patients. Regions 4 and 8 of Sugarbaker's PCI had the highest incidence of occult disease and regions 9 and 10 the lowest. The response to chemotherapy occurred in a similar manner in over 95%- the least common site of residual disease was the small bowel mesentery, followed by upper regions (regions 1-3), omentum and middle regions (regions 0, 4, 8), lower regions (regions 5-7) and lastly the ovaries.</p><p><strong>Conclusions: </strong>During interval CRS, based on the disease mapping provided in this manuscript, regions that have a high probability of residual disease should be explored and dissected. Complete resection of involved the peritoneal region can completely address the occult disease. The role of resection of the entire region as well as 'normal appearing' parietal peritoneal regions should be prospectively evaluated.</p>","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":"47 1","pages":"181-187"},"PeriodicalIF":3.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.10.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38506404","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":"Surgical management of bone and soft tissue sarcomas and skeletal metastases during the COVID-19 pandemic.","authors":"Pedro Cardoso,&nbsp;Ricardo Rodrigues-Pinto","doi":"10.1016/j.ejso.2020.04.027","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.04.027","url":null,"abstract":"","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":" ","pages":"1178-1179"},"PeriodicalIF":3.8,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.04.027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37870077","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":"Coronavirus outbreak: Reorganising the breast unit during a pandemic.","authors":"Anokha O Joseph,&nbsp;Janso P Joseph,&nbsp;Bernadette Pereira,&nbsp;Jasdeep Gahir","doi":"10.1016/j.ejso.2020.04.031","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.04.031","url":null,"abstract":"","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":" ","pages":"1176-1177"},"PeriodicalIF":3.8,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.04.031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37874194","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":"Cancer surgery sustainability in the light of COVID-19 pandemic.","authors":"Afsana Elanko,&nbsp;Jim Khan,&nbsp;Zaed Zr Hamady,&nbsp;Hassan Malik","doi":"10.1016/j.ejso.2020.05.018","DOIUrl":"https://doi.org/10.1016/j.ejso.2020.05.018","url":null,"abstract":"","PeriodicalId":519500,"journal":{"name":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","volume":" ","pages":"1174-1175"},"PeriodicalIF":3.8,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejso.2020.05.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38001277","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}