A phase II clinical trial demonstrates the feasibility of mass-based response testing (MRT) in tailoring intraperitoneal chemotherapy for patients with unresectable appendiceal or colorectal peritoneal metastases. MRT assessed tumor susceptibility to various HIPEC drug regimens, offering a personalized approach to treatment. The study aims to improve outcomes by personalizing regimens based on patient-specific sensitivities, thereby […]
Category: Cytoreductive Surgery & Peritoneum
AI Framework Enhances Predictive Accuracy for Colorectal Cancer Surgery
A novel deep-learning model, known as DEAF, accurately predicts the completeness of cytoreductive surgery (CRS) in colorectal cancer patients with peritoneal metastasis. Achieving an area under the curve (AUC) of 0.9 in the internal validation cohort, and higher AUC values in three external cohorts, the model aids in selecting suitable patients for surgery and anticipating […]
Elevated preoperative tumor markers affect survival in cancer patients
Elevated preoperative levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125 (CA125) in colorectal cancer patients with peritoneal metastases significantly influence overall survival. In a study of 204 patients, the presence of high CA19-9 and CA125 was linked to poorer outcomes, with hazard ratios of 2.7 and 2.2, respectively. Histopathological features […]
Advances in managing gastric cancer with peritoneal metastasis
Recent insights into gastric cancer with peritoneal metastasis (gcpm) reveal dismal outcomes, underscoring the need for improved management strategies. A growing body of clinical trials investigates the efficacy of cytoreductive surgery (crs) combined with hyperthermic intraperitoneal chemotherapy (hipec), recognized in new national guidelines. Enhanced understanding of gcpm’s mechanisms and novel therapeutic targets could lead to […]
Cytoreductive surgery with HIPEC and IORT enhances gastric cancer survival
Findings indicate that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) and intraoperative radiation therapy (IORT) significantly improves overall survival (63 months) and disease-free survival (87 months) for gastric cancer patients. Over one-third of participants experienced no postoperative complications, while those who did faced a median of just one complication, primarily grade II. The absence […]
Identification of Key Risk Factors for Postoperative Kidney Injury
A meta-analysis of seven studies involving 1,550 patients has pinpointed significant preoperative and intraoperative risk factors for acute kidney injury (AKI) after cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). Preoperative factors include age, sex, BMI, and diabetes, while intraoperative factors include low systolic blood pressure and cisplatin use; however, mitomycin shows protective effects. Variations […]
Machine-learning model predicts postoperative infection risk after surgery
A machine-learning model, specifically the extreme gradient boost (XGBoost), was developed to predict postoperative infection following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with splenectomy. The model demonstrated excellent prediction accuracy, achieving an area under the curve (AUC) of 0.910 in preliminary testing and 0.823 in external validation. Data was analyzed from a cohort of 1,016 […]
Tumor-Stroma Ratio Accurately Predicts Peritoneal Metastasis in Gastric Cancer
Analysis reveals a strong correlation between tumor-stroma ratio (tsr) and peritoneal metastasis (pm) in gastric cancer patients. The study included 640 patients across several cohorts, establishing a diagnostic model integrating tsr with CA125, CA724, and Borrmann type. The model demonstrated robust predictive capabilities, achieving an area under the curve (AUC) of 0.85 in the training […]
Preoperative tumor markers predict surgical outcomes in peritoneal metastases
Clustering preoperative tumor marker patterns aids in predicting surgical outcomes for patients with peritoneal metastases. Among 138 with pseudomyxoma peritonei (pMP), two distinct clusters emerged—pMP cluster-1 had a 5-year overall survival rate of 77%, while pMP cluster-2 faced a significantly poorer prognosis of 36%. A similar pattern was observed in 213 colorectal peritoneal metastases patients, […]
Cytoreductive surgery improves survival in colorectal peritoneal metastases.
In patients with colorectal peritoneal metastases, cytoreductive surgery has shown significant survival benefits, regardless of the use of intraperitoneal chemotherapy. Despite recent challenges to the efficacy of intraperitoneal treatments, the comprehensive review indicates that surgical intervention remains a crucial component in managing this aggressive form of cancer. The study emphasizes a critical analysis of current […]