scholarly journals 136 Hyperthermic intraperitoneal chemotherapy for gynecologic malignancies in a community-based comprehensive cancer center: A review of morbidity and experience

2020 ◽  
Author(s):  
B Meelheim ◽  
L Deng ◽  
A Wagreich ◽  
L Gattoc ◽  
N Tchabo ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Gynecologic Malignancies ◽  
Community Based

scholarly journals Impact of insurance status on overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Ravi J. Chokshi ◽  
Jin K. Kim ◽  
Jimmy Patel ◽  
Joseph B. Oliver ◽  
Omar Mahmoud
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Abdominal Wall ◽  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Safety Net ◽  
Insurance Status ◽  
Gynecologic Malignancies ◽  
Safety Net Hospital ◽  
The Impact

AbstractObjectivesThe impact of insurance status on oncological outcome in patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is poorly understood.MethodsRetrospective study on 31 patients having undergone 36 CRS-HIPEC at a single institution (safety-net hospital) between 2012 and 2018. Patients were categorized as insured or underinsured. Demographics and perioperative events were compared. Primary outcome was overall survival (OS).ResultsA total of 20 patients were underinsured and 11 were insured. There were less gynecologic malignancies in the underinsured (p=0.02). On univariate analysis, factors linked to poor survival included gastrointestinal (p=0.01) and gynecologic malignancies (p=0.046), treatment with neoadjuvant chemotherapy (p=0.03), CC1 (p=0.02), abdominal wall resection (p=0.01) and Clavien–Dindo 3-4 (p=0.01). Treatment with neoadjuvant chemotherapy and abdominal wall resections, but not insurance status, were independently associated with OS (p=0.01, p=0.02 respectively). However, at the end of follow-up, six patients were alive in the insured group vs. zero in the underinsured group.ConclusionsIn this small, exploratory study, there was no statistical difference in OS between insured and underinsured patients after CRS-HIPEC. However, long-term survivors were observed only in the insured group.

Does the primary tumour location affect the prognosis of patients with colorectal cancer peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Haipeng Chen ◽  
Sicheng Zhou ◽  
Jianjun Bi ◽  
Qiang Feng ◽  
Zheng Jiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Primary Tumour ◽  
Cancer Center ◽  
Tumour Location ◽  
Life Threatening ◽  
Grade 3 ◽  
The Impact

Abstract Background The impact of primary tumour location on the prognosis of patients with peritoneal metastasis (PM) arising from colorectal cancer (CRC) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is rarely discussed, and the evidence is still limited. Methods Patients with PM arising from CRC treated with CRS and HIPEC at the China National Cancer Center and Huanxing Cancer Hospital between June 2017 and June 2019 were systematically reviewed. Clinical characteristics, pathological features, perioperative parameters, and prognostic data were collected and analysed. Results A total of 70 patients were divided into two groups according to either colonic or rectal origin (18 patients in the rectum group and 52 patients in the colon group). Patients with PM of a colonic origin were more likely to develop grade 3–4 postoperative complications after CRS+HIPEC (38.9% vs 19.2%, P = 0.094), but this difference was not statistically significant. Patients with colon cancer had a longer median overall survival (OS) than patients with rectal cancer (27.0 vs 15.0 months, P = 0.011). In the multivariate analysis, the independent prognostic factors of reduced OS were a rectal origin (HR 2.15, 95% CI 1.15–4.93, P = 0.035) and incomplete cytoreduction (HR 1.99, 95% CI 1.06–4.17, P = 0.047). Conclusion CRS is a complex and potentially life-threatening procedure, and we suggest that the indications for CRS+HIPEC in patients with PM of rectal origin be more restrictive and that clinicians approach these cases with caution.

scholarly journals Neoadjuvant Chemotherapy Followed by Hyperthermic Intraperitoneal Chemotherapy for Patients with Colorectal Peritoneal Metastasis: A Retrospective Study of its Safety and Efficacy

2021 ◽  
Author(s):  
Sicheng Zhou ◽  
Yujuan Jiang ◽  
Jianwei Liang ◽  
Wei Pei ◽  
Zhixiang Zhou
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Multivariable Analysis ◽  
Cancer Center ◽  
Confounding Factors ◽  
Clinicopathologic Characteristics ◽  
Safety And Efficacy ◽  
Peritoneal Carcinomatosis Index

Abstract Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are effective routine treatments for colorectal peritoneal metastases (PMs). However, the safety and efficacy of neoadjuvant chemotherapy (NAC) before CRS+HIPEC are poorly understood. Therefore, this study aimed to assess the perioperative safety and long-term efficacy for patients with synchronous colorectal PM who received NAC prior to CRS+HIPEC.Method Patients with synchronous colorectal PM who received NAC prior to CRS+HIPEC were systematically reviewed at the China National Cancer Center and Huanxing Cancer Hospital from June 2017 to June 2019. Clinicopathologic characteristics, perioperative parameters, and survival were compared between patients who underwent CRS+HIPEC with NAC (NAC group) and those who underwent CRS+HIPEC without NAC (non-NAC group).Results The study enrolled 52 patients, with 20 patients in the NAC group and 32 in the non-NAC group. In the NAC group, the proportion of patients with a peritoneal carcinomatosis index (PCI) score < 12 was significantly higher than that in the non-NAC group (80.0% vs 50.0%, P=0.031), and more patients received complete cyoreduction (80.0% vs 46.9%, P=0.018). The two groups had comparable grade III/IV complications and similar reoperation and mortality rates (P>0.05). However, patients who received NAC prior to CRS+HIPEC experienced lower platelet counts (151.9 vs 197.7 ×109/L, P=0.036) and neutrophil counts (4.7 vs 7.2×109/L, P=0.030) on postoperative day 1. Compared with the non-NAC group, more patients in the NAC group survived for two years (67.4% vs. 32.2%, respectively, P = 0.044). However, the CC score (HR, 2.99; 95% CI, 1.14-7.84; P=0.026), rather than NAC, was independently associated with OS in the multivariable analysis after controlling for confounding factors.Conclusion NAC administration before CRS+HIPEC can be regarded as a safe and feasible treatment for patients with colorectal PM with comparably low mortality and acceptable morbidity. Nevertheless, the administration of NAC before CRS+HIPEC conferred a greater survival benefit to patients, even though NAC was not identified as an independent factor for OS after controlling for confounding factors.

CYTOREDUCTIVE SURGERY IN THE TREATMENT OF ADVANCED OVARIAN CANCER: A COMPARATIVE ANALYSIS OF THE RESULTS

2019 ◽  
Vol 65 (1) ◽  
pp. 142-146
Author(s):  
Aleksey Shelekhov ◽  
Viktoriya Dvornichenko ◽  
Sergey Radostev ◽  
Rodion Rasulov ◽  
Dmitriy Morikov ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Operation Time ◽  
Cancer Center ◽  
Significant Difference ◽  
Disease Free

The first experience of cytoreductive surgery technology and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) usage in the practice of Irkutsk Regional Cancer Center. All subjects were divided into 2 groups: the group of clinical comparison - the patients after suboptimal cytoreduction (53 persons), and the main group - the patients after optimal or complete debulking operation and hyperthermic intraperitoneal chemotherapy in some cases (32 persons). The subjects had ovarian cancer. The indispensable prerequisite of picking was confirmed carcinomatous peritoneal spread, resectable process, overall status. The primary analysis assay included time factors such as preoperation period, operation time, postoperative bed-days, in plus, complications and their character in postoperative period. In the article there are statistics of disease-free and overall survival in all groups and full consistent outline of the intraoperative hyperthermic chemotherapy method. The research has prospective character, observation continued. Expected results will be significant difference of disease-free and overall survival in the groups of interest.

Embedding palliative care (pc) in a community-based cancer center: Benefits and barriers.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 153-153
Author(s):  
Jennifer Bayne ◽  
John Weems ◽  
Robert D. Siegel ◽  
Teresa N. Bowen ◽  
Leigh Stinnett ◽  
...  
Keyword(s):  
Palliative Care ◽  
South Carolina ◽  
Symptom Management ◽  
Hospital Admissions ◽  
Disease Process ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Full Time ◽  
Community Based ◽  
Oncology Patients

153 Background: The importance of involving PC early in the disease process of oncology patients is well documented. Decreased symptom burden, increased quality of life, and extended survival are proven outcomes; however, the provision of PC has largely been limited to the acute care setting in most institutions. Bon Secours St. Francis Health System, a community based healthcare system in Greenville, South Carolina, opened a comprehensive cancer center in late 2014. Our established inpatient PC team began seeing outpatients at the cancer center shortly after its opening. Methods: PC at the cancer center is provided in an “embedded” model of care. PC appointments were initiated at 20 hours/week and have been expanded to 28 hours/week, currently provided by NPs 24 hrs, MD 4 hrs, all of whom are certified in hospice and palliative care. Patients are seen during medical oncology, radiation oncology, or infusion appointments. In August 2015, the PC team began to participate in an interdisciplinary team meeting, reviewing new oncology patients and their expected or known needs. Results: Total visits for 2015: 559/158 new patients seen. Informal interviews from patients, oncology, and PC staff revealed the following benefits: better communication regarding treatment plans; improved symptom management; flexibility and convenience in meeting patients anywhere in the cancer center and; providing resources for staff regarding pain and symptom management and communication techniques. Barriers identified were: scheduling conflicts for patients with multiple appointments; less than full-time coverage by PC prohibits some patients from being seen during their oncology appointments; PC and oncology being separate administrative entities has required creative solutions in billing and staffing. Conclusions: Despite some barriers, the benefits of embedding a PC clinic in a community-based oncology center are clear and worthwhile. This clinic improves coordination of care between inpatient and outpatient services, which results in positive patient experiences. It is hoped that the early integration of PC in the ambulatory setting will result in a decrease in avoidable emergency room visits and hospital admissions.

scholarly journals Neoadjuvant chemotherapy followed by hyperthermic intraperitoneal chemotherapy for patients with colorectal peritoneal metastasis: a retrospective study of its safety and efficacy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sicheng Zhou ◽  
Yujuan Jiang ◽  
Jianwei Liang ◽  
Wei Pei ◽  
Zhixiang Zhou
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Intraperitoneal Chemotherapy ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Survival Rates ◽  
Mortality Rates ◽  
Cancer Center ◽  
Clinicopathologic Characteristics ◽  
Safety And Efficacy ◽  
Randomized Controlled Studies

Abstract Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are effective routine treatments for colorectal peritoneal metastasis (PM). However, the safety and efficacy of neoadjuvant chemotherapy (NAC) before CRS+HIPEC are poorly understood. Therefore, this study aimed to assess the perioperative safety and long-term efficacy of NAC prior to CRS+HIPEC for patients with synchronous colorectal PM. Methods Patients with synchronous colorectal PM who received NAC prior to CRS+HIPEC were systematically reviewed at the China National Cancer Center and Huanxing Cancer Hospital from June 2017 to June 2019. The clinicopathologic characteristics, perioperative parameters, and survival rates of patients who underwent CRS+HIPEC with NAC (NAC group) and patients who underwent CRS+HIPEC without NAC (non-NAC group) were compared. Results The study enrolled 52 patients, with 20 patients in the NAC group and 32 in the non-NAC group. In the NAC group, the proportion of patients with a peritoneal carcinomatosis index (PCI) score < 12 was significantly higher than that in the non-NAC group (80.0% vs 50.0%, P = 0.031), and more patients achieved complete cytoreduction (80.0% vs 46.9%, P = 0.018). The two groups had comparable grade III/IV complications and similar reoperation and mortality rates (P > 0.05). However, patients who received NAC had lower platelet counts (151.9 vs 197.7 × 109/L, P = 0.036) and neutrophil counts (4.7 vs 7.2 × 109/L, P = 0.030) on postoperative day 1. More patients survived for 2 years in the NAC group than in the non-NAC group (67.4% vs 32.2%, respectively, P = 0.044). However, the completeness of cytoreduction score (HR, 2.99; 95% CI, 1.14–7.84; P = 0.026), rather than NAC, was independently associated with overall survival (OS) in the multivariate analysis after controlling for confounding factors. Conclusion NAC administration before CRS+HIPEC can be regarded as safe and feasible for patients with colorectal PM with comparably low mortality rates and acceptable morbidity rates. Nevertheless, large-sample randomized controlled studies are needed to confirm whether the administration of NAC before CRS+HIPEC confers a survival benefit to patients.

scholarly journals Does Primary Tumour Location Affect the Prognosis of Patients with Colorectal Cancer Peritoneal Metastases Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy?

2021 ◽  
Author(s):  
Haipeng Chen ◽  
Sicheng Zhou ◽  
Jianjun Bi ◽  
Qiang Feng ◽  
Zheng Jiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Primary Tumour ◽  
Cancer Center ◽  
Tumour Location ◽  
Life Threatening ◽  
Grade 3 ◽  
The Impact

Abstract Background The impact of primary tumour location on the prognosis of patients with peritoneal metastasis (PM) arising from colorectal cancer (CRC) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is rarely discussed, and the evidence is still limited.Methods Patients with PM arising from CRC treated with CRS and HIPEC at the China National Cancer Center and Huanxing Cancer Hospital between June 2017 and June 2019 were systematically reviewed. Clinical characteristics, pathological features, perioperative parameters, and prognostic data were collected and analysed.Results A total of 70 patients were divided into two groups according to colonic or rectal origin (18 patients in the rectum group and 52 patients in the colon group). Patients with PM of colonic origin were more likely to develop grade 3-4 postoperative complications after CRS+HIPEC (38.9% vs 19.2%, P=0.094), but this difference was not statistically significant. Patients with colon cancer had a longer median overall survival (OS) than patients with rectal cancer (27.0 vs 15.0 months, P=0.011). On the multivariate analysis, independent prognostic factors of reduced OS were rectal origin (HR 2.03, 95% CI 1.02–4.24, P = 0.044) and incomplete cytoreduction (HR 2.33, 95% CI 1.05-5.28, P = 0.039).Conclusion CRS is an originally complex and potentially life-threatening procedure, and we suggest that the indications for CRS+HIPEC in patients with PM of rectal origin be more restrictive and cautious.

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