Diagnostic Nodes of Patient Selection for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Among Colorectal Cancer Patients: A Swiss National Multicenter Survey.

Details

Serval ID
serval:BIB_A52BDCE5AABD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diagnostic Nodes of Patient Selection for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Among Colorectal Cancer Patients: A Swiss National Multicenter Survey.
Journal
Clinical colorectal cancer
Author(s)
Steffen T., Putora P.M., Hübner M., Gloor B., Lehmann K., Kettelhack C., Adamina M., Peterli R., Schmidt J., Ris F., Glatzer M.
ISSN
1938-0674 (Electronic)
ISSN-L
1533-0028
Publication state
Published
Issued date
12/2019
Peer-reviewed
Oui
Volume
18
Number
4
Pages
e335-e342
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
The management of patients with colorectal cancer (CRC) with peritoneal metastases is challenging, and the roles of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are unclear and debated among experts.
The experts of the Swiss Peritoneal Cancer Group were contacted and agreed to participate in this analysis. Experts from 9 centers in Switzerland provided their decision algorithms for CRS/HIPEC for patients with or at high risk for peritoneal metastases from CRC. Their responses were converted into decision trees on the basis of objective consensus methodology. The decision trees were used as a basis to identify consensus and discrepancies.
The final treatment algorithms included a total of 5 decision criteria (age, Peritoneal Cancer Index [PCI], extraperitoneal metastases, Peritoneal Surface Disease Severity Score, and various risk factors [RF]) and 2 treatment options (HIPEC, yes or no). HIPEC was never recommended for patients without peritoneal metastases in the absence of RF for peritoneal metastases. For patients with a PCI ≤15 without organ metastases, all centers recommended CRS/HIPEC. There was also a consensus not to perform CRS/HIPEC in elderly patients (80 years and older), those with a PCI >20, and those with unresectable metastases. For patients with a PCI = 16 to 20, there was no consensus.
Multiple decision criteria relevant to all participating centers were identified. Because patient selection for CRS/HIPEC remains difficult, uniform criteria for the term "high risk" for peritoneal metastases and systemic metastases are helpful. Future trials and guidelines should take these criteria into account.
Keywords
Age Factors, Colorectal Neoplasms/pathology, Colorectal Neoplasms/therapy, Combined Modality Therapy, Cytoreduction Surgical Procedures/methods, Decision Making, Disease Management, Humans, Hyperthermia, Induced/methods, Patient Selection, Percutaneous Coronary Intervention/methods, Peritoneal Neoplasms/secondary, Peritoneal Neoplasms/therapy, Practice Patterns, Physicians'/standards, Surveys and Questionnaires, Switzerland, Colorectal cancer, Cytoreductive surgery, HIPEC, Patient selection, Peritoneal malignancy
Pubmed
Web of science
Create date
18/08/2019 16:18
Last modification date
12/08/2020 6:22
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