scholarly journals THE ROLE OF HIPEC IN PERITONEAL CARCINOMATOSIS DUE TO COLORECTAL CANCER – PROCEDURE, COMPLICATIONS, AND LITERATURE EVIDENCE

2020 ◽  
Vol 7 (3) ◽  
pp. 99-105
Author(s):  
Iulian Slavu ◽  
Adrian Tulin ◽  
Bogdan Socea ◽  
Dan Nicolae Păduraru ◽  
Vlad Braga ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Peritoneal Carcinomatosis ◽  
Randomized Clinical Trials ◽  
Correct Selection ◽  
Time Interval ◽  
Literature Evidence ◽  
Oncological Centers ◽  
Increase Survival Time ◽  
Medical Teams

Cytoreductive surgery and HIPEC have become de pillars of treatment in advanced, metastatic colorectal cancer. This state of evolution of the disease was considered terminal just a few years ago.  It has been demonstrated that by combining these therapies in selected patients one can increase survival time. Once this has been obtained to some length modern studies have been focused on the quality of life, safety, and how this time interval can be increased. We have reviewed the most important prospective, randomized clinical trials regarding HIPEC and peritoneal carcinomatosis. The technique, complications, principles of action, and evolution through time of HIPEC have been addressed and covered. Special consideration had been given to the correlation between the carcinomatosis index and HIPEC. HIPEC with maximal cytoreduction can be considered a curative procedure only in strictly selected patients diagnosed with colorectal cancer and peritoneal carcinomatosis. Although it has been present in the medical field for almost 30 years, it is not wide-spread due to the high costs of implementation and the requirement of highly specialized surgical and medical teams. As technology evolves, the costs can be decreased and HIPEC should be largely available in oncological centers since the foundation of implementation is solid and the fact that clear benefits although small have been demonstrated. Taking into account all of the above, HIPEC should not be considered a standard treatment at present and should only be performed in experienced centers. The correct selection of patients is critical to the success of this procedure. Maximum cytoreduction should only be performed if the carcinomatosis index allows.  

Role of radiofrequency ablation in the treatment of liver metastases from colorectal cancer: Pooled analysis of randomized clinical trials.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e14557-e14557
Author(s):  
Fabrizio Drudi ◽  
Emiliano Tamburini ◽  
Manuela Fantini ◽  
Antonio Polselli ◽  
Lucia Stocchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trials ◽  
Radiofrequency Ablation ◽  
Liver Metastases ◽  
Randomized Clinical Trials ◽  
Pooled Analysis

scholarly journals Do we still need CRS and HIPEC in colorectal cancer in times of modern chemotherapy and immunotherapy?

2020 ◽  
Vol 13 (4) ◽  
pp. 430-433 ◽  
Author(s):  
Elisabeth Gasser ◽  
Pamela Kogler ◽  
Andreas Lorenz ◽  
Reinhold Kafka-Ritsch ◽  
Dietmar Öfner ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Peritoneal Carcinomatosis ◽  
Poor Prognosis ◽  
Tumor Tissue ◽  
Residual Tumor ◽  
Short Review ◽  
Primary Surgery ◽  
Risk Patients ◽  
Crs And Hipec

SummaryPeritoneal carcinomatosis from colorectal cancer is associated with a poor prognosis and is usually treated with systemic chemotherapy and immunotherapy alone. In patients with isolated peritoneal carcinomatosis (PC) without nonperitoneal metastases, however, cytoreductive surgery (CRS) has been shown to significantly improve outcome and to achieve even cure in selected patients in combination with systemic therapy. The additional use of a hyperthermic intraperitoneal chemotherapy (HIPEC) is primarily indicated to control microscopical residual tumor tissue in the peritoneal cavity after successful CRS. Another more recent option is the application of an adjuvant HIPEC to prevent peritoneal carcinomatosis in high risk patients with pT4 cancer or perforated cancer at the time of or after primary surgery. The aim of this short review is to highlight the corresponding available literature and assess the role of CRS and HIPEC in the context of modern chemotherapy and immunotherapy.

Effect of Dipyridamole on Spontaneous Platelet Aggregation in Whole Blood Decreases with the Time After Venepuncture: Evidence for the Role of ADP

1987 ◽  
Vol 58 (02) ◽  
pp. 744-748 ◽  
Author(s):  
A R Saniabadi ◽  
G D O Lowe ◽  
J C Barbenel ◽  
C D Forbes
Keyword(s):  
Platelet Aggregation ◽  
Correlation Coefficient ◽  
Whole Blood ◽  
Blood Platelet ◽  
Inhibitory Effect ◽  
Time Interval ◽  
Adp Receptor ◽  
Spontaneous Platelet Aggregation

SummarySpontaneous platelet aggregation (SPA) was studied in human whole blood at 3, 5, 10, 20, 30, 40 and 60 minutes after venepuncture. Using a whole blood platelet counter, SPA was quantified by measuring the fall in single platelet count upon rollermixing aliquots of citrated blood at 37° C. The extent of SPA increased with the time after venepuncture, with a correlation coefficient of 0.819. The inhibitory effect of dipyridamole (Dipy) on SPA was studied: (a) 10 μM at each time interval; (b) 0.5-100 μM at 3 and 30 minutes and (c) 15 μM in combination with 100 μM adenosine, 8 μM 2-chloroadenosine (2ClAd, an ADP receptor blocker) and 50 μM aspirin. There was a rapid decrease in the inhibitory effect of Dipy with the time after venepuncture; the correlation coefficient was -0.533. At all the concentrations studied, Dipy was more effective at 3 minutes than at 30 minutes after venepuncture. A combination of Dipy with adenosine, 2ClAd or aspirin was a more effective inhibitor of SPA than either drug alone. However, when 15 μM Dipy and 10 μM Ad were added together, the inhibitory effect of Dipy was not increased significantly, suggesting that Dipy inhibits platelet aggregation independent of Ad. The increase in SPA with the time after venepuncture was abolished when blood was taken directly into the anticoagulant containing 5 μM 2ClAd. It is suggested that ADP released from the red blood cells is responsible for the increased platelet aggregability with the time after venepuncture and makes a serious contribution to the artifacts of in vitro platelet function studies.

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