A recent consensus on managing peritoneal mesothelioma reaffirms critical treatment strategies. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the standard for completely resectable cases. Strong agreement on using cisplatin-doxorubicin for HIPEC in routine care and performing a total parietal peritonectomy for all patients. Neoadjuvant chemotherapy recommended for patients with sarcomatoid or biphasic subtypes and […]
Category: Cytoreductive Surgery & Peritoneum
Cytoreductive Surgery Best Practices for Peritoneal Malignancies
New guidelines for cytoreductive surgery (CRS) emphasize improved patient outcomes through standardized techniques. 81.5% consensus on 31 of 38 key surgical questions, indicating areas of agreement among leading surgeons. Strong recommendation for specialist pathologists and thorough evaluations of CRS specimens. Standardized practices can enhance surgical precision and patient selection, potentially reducing complications in high-stakes procedures. […]
CRS/HIPEC Improves Survival in Low-Grade Appendiceal Carcinoma
CRS/HIPEC significantly enhances survival for select low-grade appendiceal carcinoma patients with peritoneal and parenchymal metastases. Median overall survival (OS) for low-grade mucinous and non-mucinous patients after CRS/HIPEC was not reached, compared to 50 months for surgery alone and 26 months for systemic chemotherapy (p < 0.01). In multivariable analysis, CRS/HIPEC reduced mortality risk for low-grade […]
Prophylactic CRS and HIPEC Elevate Outcomes in Appendiceal Cancer
Prophylactic cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) offers significantly improved survival for patients with perforated appendiceal adenocarcinoma. Five-year overall survival with prophylactic CRS + HIPEC was 96.9% vs. 51.9% for conventional carcinologic resection. Five-year disease-free survival was 75.2% with prophylactic treatment compared to 34.3% in the standard group. This approach should be a standard […]
Gastric Cancer Treatment Shift: Prioritizing Patient Outcomes
Gastric cancer with peritoneal metastases is rising, especially in younger patients, highlighting the urgent need for better outcomes. Novel therapies like normothermic intraperitoneal and systemic chemotherapy have shown overall survival benefits. Patient-reported outcomes remain underreported in major trials, with critical insights missed from studies like Dragon-01. Incorporating tailored patient-reported measures into clinical trials is essential […]
Efficacy of HIPEC After Laparoscopic Gastrectomy in Gastric Cancer
Laparoscopic gastrectomy plus hyperthermic intraperitoneal chemotherapy (HIPEC) improves outcomes for gastric cancer patients with positive peritoneal lavage cytology. HIPEC-treated patients had significantly lower postoperative recurrence (66.7% vs. 90.9%) and visible metastasis (29.6% vs. 59.1%, p < 0.05). 3-year overall survival for HIPEC patients was 51.8% versus 18.2% for non-HIPEC (p = 0.005). Consider HIPEC for […]
Endosonography-guided Coloenterostomy Offers Major Survival Benefits in Palliative Care
Endosonography-guided coloenterostomy (CE) significantly enhances outcomes for patients with small-bowel ileus due to peritoneal carcinomatosis. In a cohort of 17 patients, CE achieved a 94% technical success rate, with most experiencing symptom relief and improved quality of life. Notably, overall survival spanned 86 days compared to 14 days with conventional gastrostomy. Moreover, over half had […]
Tailored Surveillance Improves Outcomes in Mucinous Appendix Cancer
Mucinous appendix cancer (MAC) recurrence varies significantly by histology and critical postoperative periods. In a study of 385 patients, relapse risk was highest shortly after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: 1.0, 2.6, and 3.8 per 10 person-years for low-grade, high-grade, and signet-ring cell cancers, respectively. Researchers recommend individualized follow-up schedules every 5.5 to 18 […]
CRS Plus HIPEC Outperforms CRS Alone in Quality of Life for Cancer Patients
Patients with colorectal cancer receiving cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS plus HIPEC) experience significantly improved quality of life (QoL) compared to those undergoing CRS alone. Results indicate a notable minimal clinically important difference (MCID) favoring the HIPEC group, with improvement often evident within three months. Deterioration in MCID correlates with factors such as […]
Cytoreductive surgery halves death risk in colorectal peritoneal metastasis.
Cytoreductive surgery markedly improves overall survival in colorectal peritoneal metastasis compared to modern systemic therapies alone. A systematic review of 3316 patients reveals a pooled hazard ratio of 0.447, indicating nearly a 55% reduction in the risk of death. This benefit persists across various palliative treatments, demonstrating robust effectiveness despite variations in therapy intensity. With […]