Laparoscopic cytoreductive surgery and HIPEC for peritoneal metastases of colorectal origin

2022 ◽  
Author(s):  
Marco Tonello ◽  
Carola Cenzi ◽  
Elisa Pizzolato ◽  
Antonio Sommariva ◽  
Pierluigi Pilati
Keyword(s):  
Cytoreductive Surgery ◽  
Peritoneal Metastases ◽  
Colorectal Origin

Peritoneal metastases of colorectal origin – cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The financial aspect

2017 ◽  
Vol 89 (6) ◽  
pp. 1-6
Author(s):  
Tomasz Jastrzębski ◽  
Marek Bębenek
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Distant Metastases ◽  
Peritoneal Metastases ◽  
Medical Procedures ◽  
Financial Loss ◽  
Colorectal Origin ◽  
Crs And Hipec ◽  
Financial Aspect

About 10% to 15% of patients with colon cancer have intraperitoneal metastases at diagnosis. The patients with intraperitoneal metastases and without distant metastases can benefit from cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Because up to a half of patients live for at least 5 years after this treatment, the treatment is used more and more often. The treatment of patients with intraperitoneal metastases with CRS and HIPEC costs more than the majority of other medical procedures, because CRS is extensive and takes a lot of time, and after surgery, patients need intensive care and expensive medications and equipment. Currently, only 40% to 80% of costs of CRS and HIPEC are reimbursed in Poland. Because CRS and HIPEC mean a financial loss to hospitals, they are rarely performed. We analyzed the costs of treating patients with peritoneal metastases by CRS and HIPEC in two centers (Gdank, Wroclaw) and showed how this treatment is reimbursed outside Poland. We discussed whether adequate qualification of patients and experience of the teams giving the treatment could reduce the costs.

Multimodal fluorescence-guided surgery of colorectal peritoneal metastases, a phase I/II clinical trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS4119-TPS4119
Author(s):  
Jan-Marie de Gooyer ◽  
Fortuné Elekonawo ◽  
Andre J.A. Bremers ◽  
Otto Boerman ◽  
Mark Rijpkema ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Phase I ◽  
Peritoneal Carcinomatosis ◽  
Real Time ◽  
Fluorescence Imaging ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastases ◽  
Colorectal Origin ◽  
Intraoperative Fluorescence Imaging ◽  
Intraoperative Fluorescence

TPS4119 Background: Successful treatment of patients with colorectal peritoneal carcinomatosis highly depends on complete surgical tumor resection of all tumor. Oncological outcomes can potentially be improved by intraoperative imaging using a tumor-targeting antibody conjugated to a fluorophore and a radiotracer. This enables preoperative radionuclide imaging, real-time intraoperative fluorescence imaging and gamma detection. In this study we investigate the feasibility, accuracy and safety of CEA-targeted preoperative SPECT/CT and intraoperative fluorescence imaging in patients with colorectal PC. Methods: In this phase I/II single arm protein dose escalation study patients with peritoneal metastases of colorectal origin who are scheduled for cytoreductive surgery and HIPEC will receive an intravenous injection of the CEA-targeting tracer 111In-DOTA-labetuzumab-IRDye800CW. The first 15 patients will receive a single dose of 2,10 or 50 mg 6 to 7 days prior to surgery. Four to five days after injection SPECT/CT imaging of the thorax and abdomen is performed to determine intra-abdominal tumor load and detect extra-abdominal metatases. At day 6/7 after injection, standard cytoreductive surgical resection extended with real-time near-infrared fluorescence imaging and radio guidance is performed. After surgery, the peritoneal cavity will be re-examined for residual disease with fluorescence imaging. Resected specimens are analyzed microscopically, immunohistochemically (CEA and H&E) and by gamma counting. Blood samples are drawn for farmacokinetics and safety analysis at 180 minutes, 4 days, 6 days and 3 weeks after tracer injection. In the phase II dose expansion cohort, 14 more patients will receive the optimal dose as determined in the phase I trial. The primary objectives of the trial are to assess the safety, feasibility and accuracy of preoperative SPECT/CT and intraoperative fluorescence imaging after administration of 111In- labetuzumab-IRDye800CW in patients with peritoneal carcinomatosis of colorectal origin who will undergo cytoreductive surgery and HIPEC. The secondary objectives are to assess whether additional malignant lesions can be visualized by fluorescence imaging after cytoreductive surgery, to assess the intensity of fluorescence in malignant and non-malignant tissue, to assess the correlation between localization of the dual-labeled antibody and CEA expression in tumor and healthy tissue and to determine blood concentrations of the dual labelled antibody at several time points in patients. Clinical trial information: NCT03699332 .

scholarly journals Correction to: Primary Tumor Location and Outcomes After Cytoreductive Surgery and Intraperitoneal Chemotherapy for Peritoneal Metastases of Colorectal Origin

2020 ◽  
Vol 27 (S3) ◽  
pp. 987-987
Author(s):  
Mohammad Adileh ◽  
Jonathan B. Yuval ◽  
Henry S. Walch ◽  
Walid K. Chatila ◽  
Rona Yaeger ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Primary Tumor ◽  
Tumor Location ◽  
Peritoneal Metastases ◽  
Primary Tumor Location ◽  
Colorectal Origin

Cytoreductive surgery and heated intra-peritoneal chemotherapy in the treatment of peritoneal carcinomatosis of colorectal origin: The need for practice altering data

2008 ◽  
Vol 98 (6) ◽  
pp. 397-398 ◽  
Author(s):  
Jesus Esquivel ◽  
Aviram Nissan ◽  
Alexander Stojadinovic
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Cytoreductive Surgery ◽  
Colorectal Origin
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