Rafael Morales-Soriano1, Neus Esteve-Pérez2, Juan José Segura-Sampedro3, Pedro Cascales-Campos4, Pedro Barrios5. 1. Peritoneal Surgical Oncology Unit, Department of General & Digestive Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Malignant Peritoneal Disease Research Group, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain. Electronic address: rafa.morales@telefonica.net. 2. Malignant Peritoneal Disease Research Group, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; Department of Anesthesiology, Hospital Universitario Son Espases, Palma de Mallorca, Spain. 3. Peritoneal Surgical Oncology Unit, Department of General & Digestive Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Malignant Peritoneal Disease Research Group, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain. 4. Peritoneal Carcinomatosis Unit, Department of Surgery, Hospital Universitario Virgen De La Arrixaca, Murcia, Spain. 5. Peritoneal Carcinomatosis Unit, Department of Surgery, Hospital Sant Joan Despí, Moisès Broggi, Spain.
Abstract
INTRODUCTION: Radical Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), has been proposed as the current standard of treatment for metastatic peritoneal disease by several tumors. Despite its widely utilization, there seems to be a great variability in their organization, clinical practice, and safety among centers. AIM OF THE STUDY: To obtain updated information on clinical practice in different perioperative areas of the CRS-HIPEC. PATIENTS AND METHODS: All 25 members of the Spanish Surface Peritoneal Malignancy (GECOP), were invited to answer an online survey, to describe their usual practice in different perioperative areas of the CRS-HIPEC. RESULTS: Survey was responded by 100% of centers. This study represents more than 800 patients treated annually. Seventy per cent of respondents perform CRS-HIPEC for more than 5 years. The most frequent technique was Coliseum (88%). Routinely non-invasive monitoring of cardiac output is used by 92% of centers. More than 50% of centers administer oxaliplatin (74%), or mitomycin-C (65%) in colorectal cancer; cisplatin in gastric cancer (73%) and mesothelioma (74%). Ovarian cancer is treated with cisplatin and various combinations, in 64% or paclitaxel in 54.5%. Spillage protocol was available in 100% centers. CONCLUSIONS: Data showed an important variability in volume of patients per center, selection of cytostatic agents, professional training and safety measures applied. The standardization of CRS/HIPEC procedures based on the best available evidence, the individualization of patients and the consensus among professionals, constitute an important part of the basis that will allow us to improve results of this complex procedure.
INTRODUCTION: Radical Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), has been proposed as the current standard of treatment for metastatic peritoneal disease by several tumors. Despite its widely utilization, there seems to be a great variability in their organization, clinical practice, and safety among centers. AIM OF THE STUDY: To obtain updated information on clinical practice in different perioperative areas of the CRS-HIPEC. PATIENTS AND METHODS: All 25 members of the Spanish Surface Peritoneal Malignancy (GECOP), were invited to answer an online survey, to describe their usual practice in different perioperative areas of the CRS-HIPEC. RESULTS: Survey was responded by 100% of centers. This study represents more than 800 patients treated annually. Seventy per cent of respondents perform CRS-HIPEC for more than 5 years. The most frequent technique was Coliseum (88%). Routinely non-invasive monitoring of cardiac output is used by 92% of centers. More than 50% of centers administer oxaliplatin (74%), or mitomycin-C (65%) in colorectal cancer; cisplatin in gastric cancer (73%) and mesothelioma (74%). Ovarian cancer is treated with cisplatin and various combinations, in 64% or paclitaxel in 54.5%. Spillage protocol was available in 100% centers. CONCLUSIONS: Data showed an important variability in volume of patients per center, selection of cytostatic agents, professional training and safety measures applied. The standardization of CRS/HIPEC procedures based on the best available evidence, the individualization of patients and the consensus among professionals, constitute an important part of the basis that will allow us to improve results of this complex procedure.
Authors: Nick Seyfried; Can Yurttas; Markus Burkard; Benedikt Oswald; Alexander Tolios; Franziska Herster; Joseph Kauer; Tarkan Jäger; Ingmar Königsrainer; Karolin Thiel; Markus Quante; Hans-Georg Rammensee; Sascha Venturelli; Matthias Schwab; Alfred Königsrainer; Stefan Beckert; Markus W Löffler Journal: Cancers (Basel) Date: 2022-02-24 Impact factor: 6.639