scholarly journals Hyperthermic Intraperitoneal Chemotherapy: A Critical Review

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3114
Author(s):  
Wim Ceelen ◽  
Jesse Demuytere ◽  
Ignace de Hingh
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Imaging Techniques ◽  
Systemic Exposure ◽  
Theoretical Concept ◽  
Chemotherapeutic Agents ◽  
Peritoneal Metastases ◽  
Attractive Alternative ◽  
True Value ◽  
Heated Intraperitoneal Chemotherapy ◽  
Study Results

With increasing awareness amongst physicians and improved radiological imaging techniques, the peritoneal cavity is increasingly recognized as an important metastatic site in various malignancies. Prognosis of these patients is usually poor as traditional treatment including surgical resection or systemic treatment is relatively ineffective. Intraperitoneal delivery of chemotherapeutic agents is thought to be an attractive alternative as this results in high tumor tissue concentrations with limited systemic exposure. The addition of hyperthermia aims to potentiate the anti-tumor effects of chemotherapy, resulting in the concept of heated intraperitoneal chemotherapy (HIPEC) for the treatment of peritoneal metastases as it was developed about 3 decades ago. With increasing experience, HIPEC has become a safe and accepted treatment offered in many centers around the world. However, standardization of the technique has been poor and results from clinical trials have been equivocal. As a result, the true value of HIPEC in the treatment of peritoneal metastases remains a matter of debate. The current review aims to provide a critical overview of the theoretical concept and preclinical and clinical study results, to outline areas of persisting uncertainty, and to propose a framework to better define the role of HIPEC in the treatment of peritoneal malignancies.

Preoperative performance status predicts outcome following heated intraperitoneal chemotherapy

2008 ◽  
Vol 196 (6) ◽  
pp. 909-914 ◽  
Author(s):  
Nathaniel P. Reuter ◽  
Jay M. MacGregor ◽  
Charles E. Woodall ◽  
Robert P. Sticca ◽  
C. William ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Performance Status ◽  
Heated Intraperitoneal Chemotherapy

Conflicting Data on the Incidence of Leukopenia and Neutropenia After Heated Intraperitoneal Chemotherapy with Mitomycin C

2017 ◽  
Vol 24 (13) ◽  
pp. 3831-3836 ◽  
Author(s):  
Yael Feferman ◽  
Shanel Bhagwandin ◽  
Joseph Kim ◽  
Samantha N. Aycart ◽  
Daniela Feingold ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Intraperitoneal Chemotherapy ◽  
Heated Intraperitoneal Chemotherapy

Factors Predictive of Outcomes after Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Colon and Appendiceal Carcinomatosis: A Single-Institution Experience

2018 ◽  
Vol 84 (10) ◽  
pp. 1575-1579
Author(s):  
Blake Babcock ◽  
Brice Jabo ◽  
Matthew Selleck ◽  
Mark Reeves ◽  
Carlos Garberoglio ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Lymph Node Status ◽  
Long Term Outcomes ◽  
Node Status ◽  
Heated Intraperitoneal Chemotherapy ◽  
Short And Long Term

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC), although considered an acceptable treatment option in the management of selected patients with colon and appendiceal peritoneal carcinomatosis (PC), concerns about morbidity have limited its acceptance. Our objective was to evaluate the short- and long-term outcomes of CRS/HIPEC for appendix and colon PC performed at our institution and to elucidate factors predictive of patient outcomes. All patients who underwent CRS/HIPEC for appendix or colon PC from 2011 to 2017 were identified from our institution's prospective database. Postoperative outcomes, overall survival, and recurrence-free survival were assessed. Of 125 patients who underwent CRS/HIPEC during the study period, 45 patients were eligible (appendix n = 26; colon n = 19). The median postoperative length of stay was nine days (5–28 days). Grade III/IV complications occurred in 4/45 (8.8%) patients. There were no postoperative mortalities. Median DFS and overall survival have not yet been reached, in both the colon and appendix groups. As of the study conclusion date, 37/45 (82.2%) patients were alive with or without disease. Lymph node status was predictive of recurrence in appendix PC. In our experience, CRS/HIPEC can be safely performed with acceptable short- and long-term outcomes. Lymph node status is an important predictor of recurrence.

scholarly journals Postoperative paralytic ileus after cytoreductive surgery combined with heated intraperitoneal chemotherapy

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Jesper Nors ◽  
Jonas Amstrup Funder ◽  
David Richard Swain ◽  
Victor Jilbert Verwaal ◽  
Tom Cecil ◽  
...  
Keyword(s):  
Median Time ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Paralytic Ileus ◽  
University Hospital ◽  
Nasojejunal Tube ◽  
Heated Intraperitoneal Chemotherapy ◽  
Duration Of Surgery ◽  
Crs And Hipec ◽  
Peritoneal Malignancy

AbstractBackgroundPatients with peritoneal malignancy treated by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) are prone to develop postoperative paralytic ileus (POI). POI is associated with significant increase in both morbidity and mortality. CRS and HIPEC commonly result in prolonged POI (PPOI). The objective was to clarify the extent of PPOI in patients treated by CRS and HIPEC for peritoneal malignancy.MethodsThis was a prospective multicenter study including patients operated with CRS and HIPEC at the Department of Surgery, Aarhus University Hospital, Denmark and the Peritoneal Malignancy Institute, Basingstoke, United Kingdom. A total of 85 patients were included over 5 months. Patients prospectively reported parameters of postoperative gastrointestinal function in a diary from post-operative day 1 (POD1) until discharge. PPOI was defined as first defecation on POD6 or later.ResultsMedian time to first flatus passage was 4 days (range 1–12). Median time to first defecation was 6 days (1–14). Median time to removal of nasojejunal tube was 4 days (3–13) and 7 days (1–43) for nasogastric tube. Forty-six patients (54%) developed PPOI. Patients with PPOI had longer time to first flatus (p<0.0001) and longer time to removal of nasojejunal tube (p=0.001). Duration of surgery correlated to time to first flatus (p=0.015) and time to removal of nasogastric or nasojejunal tube (p<0.0001) but not to time to first defecation (p=0.321).ConclusionsPostoperative gastrointestinal paralysis remains a common and serious problem in patients treated with CRS and HIPEC.

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