Anatomic sites of disease in colorectal cancer patients recorded at the time of cytoreductive surgery for peritoneal metastases

2022 ◽  
Author(s):  
Paul H. Sugarbaker ◽  
David Chang
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastases ◽  
Colorectal Cancer Patients

scholarly journals Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Engbersen ◽  
C. J. V. Rijsemus ◽  
J. Nederend ◽  
A. G. J. Aalbers ◽  
I. H. J. T. de Hingh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Diagnostic Laparoscopy ◽  
Controlled Trial ◽  
Peritoneal Metastases ◽  
Surgical Staging ◽  
Mri Findings ◽  
Mri Staging ◽  
Multicenter Randomized Controlled Trial ◽  
Colorectal Cancer Patients

Abstract Background Selecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging. Methods The study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI > 24) or explorative surgeries in patients with limited disease (PCI < 15). Secondary outcomes include correlations between surgical findings and MRI findings, cost-effectiveness, and quality of life (QOL) analysis. Conclusion This randomized trial determines whether MRI can effectively replace surgical staging in patients with CRCPM considered for CRS-HIPEC. Trial registration Registered in the clinical trials registry of U.S. National Library of Medicine under NCT04231175.

298. Cytoreductive surgery in colorectal cancer patients with synchronous lung metastases

2014 ◽  
Vol 40 (11) ◽  
pp. S117
Author(s):  
V. Aliev ◽  
A. Rasulov ◽  
Y.U. Barsukov ◽  
A. Allakhverdiev ◽  
D. Kuzmichev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cytoreductive Surgery ◽  
Lung Metastases ◽  
Colorectal Cancer Patients

scholarly journals Impact of Mitomycin-C-Induced Neutropenia after Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery in Colorectal Cancer Patients with Peritoneal Carcinomatosis

2021 ◽  
Author(s):  
Suk Jun Lee ◽  
Youngbae Jeon ◽  
Hae Won Lee ◽  
Jeonghyun Kang ◽  
Seung Hyuk Baik ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Mitomycin C ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Severe Neutropenia ◽  
Crs And Hipec ◽  
Colorectal Cancer Patients

Abstract Background Mitomycin-C (MMC) is the most commonly used chemotherapeutic agent for hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS). However, MMC has a side effect of myelosuppression. This study aimed to evaluate the clinical manifestations and impact of MMC-induced neutropenia after CRS and HIPEC in colorectal cancer patients. Methods A total of 124 colorectal cancer patients who underwent CRS with HIPEC between March 2015 and January 2019 were evaluated. Patients with malignancies of non-colorectal origin, hospital stay longer than 60 days, peritoneal cancer index > 30, and complete cytoreduction score > 2 were excluded. MMC 35 mg/m2 was administered for 90 min at 41–43 °C. The patients were divided into three groups: no neutropenia, mild neutropenia (grade 1–2), and severe neutropenia (grade 3–4). Results In total, mild and severe neutropenia occurred in 30 (24.2%) and 48 (38.7%) patients, respectively. Age and body surface area were significantly different among the neutropenia groups. Severe neutropenia developed significantly earlier than mild neutropenia (6.9 days vs. 10.4 days, p < 0.001) and also lasted significantly longer (4.6 days vs. 2.5 days, p = 0.005). The rate of major postoperative complications was significantly higher in the severe neutropenia group than in the no and mild neutropenia groups (8.3% vs. 6.7% vs. 6.5%, p = 0.015) Conclusions Severe neutropenia starts earlier and lasts longer than mild neutropenia after CRS and HIPEC using an MMC triple method. The higher rate of major postoperative complications in patients with severe neutropenia highlights the importance of postoperative management during the neutropenia period.

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