Malignant Diseases of the Peritoneum and Retroperitoneum

2017 ◽  
Author(s):  
Amanda K. Arrington
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Malignant Disease ◽  
Peritoneal Metastases ◽  
Malignant Diseases ◽  
Carcinomatosis Peritoneal ◽  
Retroperitoneal Sarcomas ◽  
Peritoneal Malignancy

The peritoneum and retroperitoneum, once considered just spaces, are now recognized as primary locations for malignancies. Spread of disease, in particular, spread of malignancy, within the peritoneum is complex but predictable. This review covers the pathophysiology, diagnosis, and treatment of malignant peritoneal tumors such as peritoneal metastases and peritoneal carcinomatosis, pseudomyxoma peritonei, and mesothelioma, including a section on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. In addition, primary malignant disease of the retroperitoneum is discussed, with particular emphasis on retroperitoneal sarcomas. This review contains 9 figures, 3 tables, and 33 references. Key words: hyperthermic intraperitoneal chemotherapy, peritoneal carcinomatosis, peritoneal malignancy, peritoneal mesothelioma, peritoneal metastasis, peritoneal tumors, pseudomyxoma peritonei, retroperitoneal malignancy, retroperitoneal sarcoma

Malignant Diseases of the Peritoneum and Retroperitoneum

2017 ◽  
Author(s):  
Amanda K. Arrington
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Malignant Disease ◽  
Peritoneal Metastases ◽  
Malignant Diseases ◽  
Carcinomatosis Peritoneal ◽  
Retroperitoneal Sarcomas ◽  
Peritoneal Malignancy

The peritoneum and retroperitoneum, once considered just spaces, are now recognized as primary locations for malignancies. Spread of disease, in particular, spread of malignancy, within the peritoneum is complex but predictable. This review covers the pathophysiology, diagnosis, and treatment of malignant peritoneal tumors such as peritoneal metastases and peritoneal carcinomatosis, pseudomyxoma peritonei, and mesothelioma, including a section on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. In addition, primary malignant disease of the retroperitoneum is discussed, with particular emphasis on retroperitoneal sarcomas. This review contains 9 figures, 3 tables, and 33 references. Key words: hyperthermic intraperitoneal chemotherapy, peritoneal carcinomatosis, peritoneal malignancy, peritoneal mesothelioma, peritoneal metastasis, peritoneal tumors, pseudomyxoma peritonei, retroperitoneal malignancy, retroperitoneal sarcoma

scholarly journals Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bertrand Trilling ◽  
Alexandre Brind’Amour ◽  
Raphael Hamad ◽  
Jean-Francois Tremblay ◽  
Pierre Dubé ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Postoperative Morbidity ◽  
Low Grade ◽  
Peritoneal Carcinomatosis Index ◽  
Second Surgery ◽  
Very High

Abstract Background Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to present the results of a planned two-step surgical strategy to decrease postoperative morbidity and improve resectability of patients with very high PCI. Methods All consecutive patients who underwent a planned two-step surgical approach for PMP between January 2012 and March 2020 were retrospectively included. This approach was offered for patients with low-grade PMP with PCI > 28 for which feasibility of a complete CRS in one operation was uncertain. The first surgery included a complete CRS of the inframesocolic compartment and omentectomy. HIPEC was delivered at the second surgery, after complete CRS of the supramesocolic compartment. Postoperative morbidity was assessed using the Clavien-Dindo classification and survival results were also collected. Results Eight patients underwent the two-step approach. The median PCI was 33 (29–39) and the median time between the two procedures was 111 days (90–212 days). One patient was deemed unresectable at the second surgery. The rate of major morbidity was 0% for the first step and 25% for the second step, with no mortality. Median follow-up was 53.8 months (3–73 months). Conclusion A two-step surgical management for low-grade PMP patients with very high PCI is safe and feasible, with acceptable postoperative morbidity and no compromise on oncological outcomes.

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.

scholarly journals Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index

2020 ◽  
Author(s):  
Bertrand Trilling ◽  
Alexandre Brind'Amour ◽  
Raphael Hamad ◽  
Jean-Francois Tremblay ◽  
Pierre Dubé ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Postoperative Morbidity ◽  
Low Grade ◽  
Peritoneal Carcinomatosis Index ◽  
Second Surgery ◽  
Very High

Abstract Background Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to present the results of a planned two-step surgical strategy to decrease postoperative morbidity and improve resectability of patients with very high PCI.Methods All patients who underwent a planned two-step surgical approach for PMP between January 2012 and March 2020 were included. Data was retrospectively reviewed and analyzed. The first surgery included a complete CRS of the inframesocolic compartment and omentectomy. HIPEC was delivered at the second surgery, after complete CRS of the supramesocolic compartment. Postoperative morbidity was assessed using the Clavien-Dindo classification and survival results were also collected. Results Eight patients underwent the two-step approach. Seven had a low-grade disease and one had a high-grade disease. The median PCI was 33 (29-39) and the median time between the two procedures was 111 days. One patient was deemed unresectable at the second surgery. The rate of major morbidity was 0% for the first step and 25% for the second step, with no mortality. Median follow-up was 53.8 months. Conclusion A two-step surgical management for low-grade PMP patients with very high PCI is safe and feasible, with acceptable postoperative morbidity and no compromise on oncological outcomes.

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