scholarly journals Therapeutic efficacy of systemic therapy for colorectal peritoneal carcinomatosis: surgeon’s perspective

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Jan Franko
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Systemic Therapy ◽  
Survival Benefit ◽  
Randomized Trials ◽  
Peritoneal Metastases ◽  
Disease Site ◽  
Peritonectomy Procedures ◽  
Systemic Therapies

AbstractTreatment choices for colorectal peritoneal carcinomatosis/metastases include systemic therapy and increasingly cytoreductive surgery with intraperitoneal chemotherapy delivery. These options are best considered as complementary and not exclusive alternatives. Two prospective randomized trials support use of peritonectomy procedures and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis. This overview examines efficacy, limitations and landscape of systemic therapy focusing on colorectal peritoneal carcinomatosis. Observations from literature support notions that (1) systemic therapy provides survival benefit for all prototypical patients with mCRC irrespective of metastatic disease site; (2) the magnitude of this benefit is considerably reduced among patients with peritoneal metastases who consequently experience significantly shorter overall survival; (3) efficacy of systemic therapy improved over time but at a slower pace for those with carcinomatosis; (4) this therapeutic difference has not diminished with introduction of targeted therapy, but perhaps widened; (5) further research of cytoreductive surgery and/or intraperitoneal regional therapies is thus a multidisciplinary responsibility of the entire oncology community; (6) peritonectomy procedures with intraperitoneal regional therapy are not scientifically supported in absence of systemic therapies.

scholarly journals Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) vs CRS alone for treatment of endometrial cancer with peritoneal metastases: a multi-institutional study from PSOGI and BIG RENAPE groups

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Manuel Gomes David ◽  
Naoual Bakrin ◽  
Julia Salleron ◽  
Marie Christine Kaminsky ◽  
Jean Marc Bereder ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Progression Free Survival ◽  
Peritoneal Metastases ◽  
Peritoneal Carcinomatosis Index ◽  
Significant Difference ◽  
Treatment Data

Abstract Objective To investigate the benefit of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of endometrial peritoneal carcinomatosis compared to CRS alone. Methods We conducted a retrospective multicentre study of patients from experienced centres in treating peritoneal malignancies from 2002 to 2015. Patients who underwent surgery for peritoneal evolution of endometrial cancer (EC) were included. Two groups of 30 women were matched and compared: “CRS + HIPEC” which used HIPEC after CRS, and “CRS only” which did not use HIPEC. We analysed clinical, pathologic and treatment data for patients with peritoneal metastases from EC. The outcome measures were morbidity, overall survival (OS), and progression-free survival (PFS). Results In “CRS plus HIPEC” group, 96.7% of women were treated for recurrence, while in “CRS only” 83.3 were treated for primary disease. There was no significant difference between Peritoneal Carcinomatosis Index at laparotomy or Completeness of Cytoreduction score. Grade III and IV complications rates did not significantly differ between “CRS plus HIPEC” group and “CRS only” group (20.7% vs 20.7%, p = 0.739). Survival analysis showed no statistical difference between both groups. Median OS time was 19.2 months in “CRS plus HIPEC” group and 29.7 months in “CRS only” group (p = 0.606). Median PFS survival time was 10.7 months in “CRS plus HIPEC” group and 13.1 months in “CRS only” group (p = 0.511). Conclusion The use of HIPEC combined to CRS did not have any significance as regard the DFS and OS over CRS alone in patients with primary or recurrent peritoneal metastasis of endometrial cancer.

scholarly journals Cytoreductive Surgery (CRS) Plus Hyperthermic Intraperitoneal Chemotherapy (HIPEC) vs CRS Alone for Treatment of Endometrial Cancer with Peritoneal Metastases: A Multi-Institutional Study from PSOGI and BIG RENAPE Groups

2021 ◽  
Author(s):  
Manuel GOMES DAVID ◽  
N. Bakrin ◽  
J. Salleron ◽  
M. C. Kaminsky ◽  
J. M. Bereder ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Progression Free Survival ◽  
Peritoneal Metastases ◽  
Peritoneal Carcinomatosis Index ◽  
Significant Difference ◽  
Treatment Data

Abstract ObjectiveTo investigate the benefit of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of endometrial peritoneal carcinomatosis compared to CRS alone.MethodsWe conducted a retrospective multicentre study of patients from experienced centres in treating peritoneal malignancies from 2002 to 2015. Patients who underwent surgery for peritoneal evolution of endometrial cancer (EC) where included. Two groups of 30 women were matched and compared: “CRS +HIPEC” which used HIPEC after CRS, and “CRS only” which did not used HIPEC. We analysed clinical, pathologic and treatment data for patients with peritoneal metastases from EC. The outcome measures were morbidity, overall survival (OS), and progression-free survival (PFS).ResultsIn “CRS plus HIPEC” group, 96,7% of women were treated for recurrence, while in “CRS only” 83,3 were treated for primary disease. There was no significant difference between Peritoneal Carcinomatosis Index at laparotomy or Completeness of Cytoreduction score. Grade III and IV complications rates did not significantly differ between “CRS plus HIPEC” group and “CRS only” group (20.7% vs 20.7%, p=0.739). Survival analysis showed no statistical difference between both groups. Median OS time was 19.2 months in “CRS plus HIPEC” group and 29.7 months in “CRS only” group (p=0.606). Median PFS survival time was 10.7 months in “CRS plus HIPEC” group and 13.1 months in “CRS only” group (p=0.511).ConclusionThe use of HIPEC combined to CRS appears to be as effective, well tolerated and feasible as CRS alone in patients with primary or recurrent peritoneal metastasis of endometrial cancer.

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