Ki-67 proliferation index was found to be associated with tumor grade in pleural epithelioid mesotheliomas, showing comparable predictability for overall survival to mitotic score. High Ki-67 index and mitoses were significantly linked to poor overall survival, suggesting that Ki-67 index by digital image analysis could serve as a reliable surrogate for tumor grade in assessing […]
Category: Cytoreductive Surgery & Peritoneum
High risk of venous thromboembolism in peritoneal mesothelioma patients highlights need for vigilant monitoring
Peritoneal mesothelioma patients had a high venous thromboembolism (VTE) risk, with 21.7% experiencing VTE, mainly symptomatic pulmonary emboli. 4-week thromboprophylaxis post-surgery resulted in acceptable 90-day VTE rates. Surgical patients and those with low serum albumin had higher VTE risk, but overall survival did not significantly differ between patients with and without VTE. These findings underscore […]
HIPEC in Appendiceal Adenocarcinoma After Perforated Appendicitis: Encouraging 5-Year Survival
Among patients diagnosed with appendiceal adenocarcinoma after acute perforated appendicitis, half may have peritoneal metastasis. Prophylactic cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in cases without identified metastasis during CRS may lead to an encouraging rate of disease-free survival at 5 years, with a recurrence rate of 12.5% and 100% overall survival. Surgical complications […]
CR/HIPEC Study Shows Decreased Opioid Use and Shortened Hospital Stay with Continuous Wound Irrigation and Intraoperative Methadone
Continuous wound irrigation and intraoperative methadone usage in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) significantly reduced opioid use and shortened length of hospital stay compared to epidural analgesia. The combination of continuous wound infusion system (CWIS) and methadone resulted in lower total and daily opioid exposure. The CWIS-only group had lower oral opioid exposure […]
Preoperative CA 19-9 predicts disease progression in colorectal peritoneal metastases treated with CRS/HIPEC
Elevated levels of CA 19-9, a tumor marker, were found to be associated with decreased progression-free survival (PFS) in patients with colorectal peritoneal metastases (CRPM) treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). The study, which included 279 patients, showed that patients with elevated CA 19-9 had a much worse PFS rate compared to […]
Normal CEA Levels Predict Improved Survival in Colorectal Peritoneal Metastases
Normal CEA levels (≤ 2.5 ng/ml) after neoadjuvant chemotherapy (NACT) and cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are associated with better survival in patients with colorectal peritoneal metastases (CRPM). A retrospective study on 253 CRPM patients showed that those with normal CEA levels after NACT had a median overall survival of 45.2 months, compared […]
Sodium thiosulfate effectively prevents cisplatin-induced nephrotoxicity in patients undergoing cytoreductive surgery with HIPEC
Sodium thiosulfate can effectively prevent cisplatin-induced nephrotoxicity in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), eliminating the need for preoperative intravenous hyperhydration. A retrospective analysis of 220 patients showed that the use of sodium thiosulfate significantly reduced serum creatinine levels and preserved glomerular filtration rate compared to hyperhydration alone or in combination with […]
Improved Short-term Outcomes of Laparoscopic CRS-HIPEC compared to Open CRS-HIPEC in Peritoneal Metastasis
Laparoscopic cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a safe and feasible procedure for selected patients with limited peritoneal disease. A retrospective analysis compared laparoscopic CRS-HIPEC to open CRS-HIPEC and found that laparoscopic procedures had lower estimated blood loss and overall morbidity rates. Grade III-IV complications, reintervention rates, and readmission rates were similar between […]
Prophylactic Hyperthermic Intraperitoneal Chemotherapy Improves Prognosis in CT4N0-1M0 Colorectal Cancer
A propensity score matching study analyzed 220 colorectal cancer patients undergoing treatment in China. Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) was associated with improved 3-year disease-free survival (DFS) compared to no HIPEC (HR 0.43). However, this benefit was not observed in patients with CT4N2M0 cancer. Laparoscopic surgery followed by HIPEC did not increase the risk of […]
Limited peritoneal disease progression in gastric cancer patients: No survival benefit with gastrectomy + cytoreductive surgery and HIPEC
The study aimed to evaluate the impact of gastrectomy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) on the outcomes of gastric cancer (GC) patients with limited peritoneal disease progression following neoadjuvant chemotherapy (NAC). Results showed that there was no survival benefit among advanced GC patients with peritoneal metastasis (PM) who underwent gastrectomy with […]