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World Journal of Gastroenterology 2008年第8期14卷 1159-1166页

作者： Hassan Alaa Hammed al-Shammaa Yan Li Yutaka Yonemura Department of Oncology Zhongnan Hospital of Wuhan University CancerCenter of Wuhan University and Hubei Cancer Clinical StudyCenter No 169 Donghu Road Wuchang District Wuhan 430071Hubei Province China peritoneal carcinomatosis program Shizuoka Cancer Center Mishima Japan

This article is to offer a concise review on the use of cytoreductive surgery （CRS） plus intraperitoneal hyperthermic chemotherapy （IPHC） for the treatment of peritoneal carcinomatosis （PC）. Traditionally, PC was treated with systemic chemotherapy alone with very poor response and a median survival of less than 6 too. With the establishment of several phase Ⅱ studies, a new trend has been developed toward the use of CRS plus IPHC as a standard method for treating selected patients with PC, in whom sufficient cytoreduction could be achieved. In spite of the need for more high quality phase Ⅲ studies, there is now a consensus among many surgical oncology experts throughout the world about the use of this new treatment strategy as standard care for colorectal cancer patients with PC. This review summarizes the current status and possible progress in future.

关键词： peritoneal carcinomatosis Cytoreductive surgery Intraperitoneal hyperthermic chemotherapy Gastric cancer Colorectal cancer Ovarian cancer peritoneal mesothelioma

Update on the prevention of local recurrence and peritoneal metastases in patients with colorectal cancer

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World Journal of Gastroenterology 2014年第28期20卷 9286-9291页

作者： Paul H Sugarbaker Center for Gastrointestinal Malignancies Program in Peritoneal Surface OncologyMedStar Washington Hospital Center

The prevention of a disease process has always been superior to the treatment of the same disease throughout the history of medicine and surgery. Local recurrence and peritoneal metastases occur in approximately 8% of colon cancer patients and 25% of rectal cancer patients and should be prevented. Strategies to prevent colon or rectal cancer local recurrence and peritoneal metastases include cytoreductive surgery and hyperthermic perioperative chemotherapy (HIPEC). These strategies can be used at the time of primary colon or rectal cancer resection if the HIPEC is available. At institutions where HIPEC is not available with the treatment of primary malignancy, a proactive second-look surgery is recommended. Several phase II studies strongly support the proactive approach. If peritoneal metastases were treated along with the primary colon resection, 5-year survival was seen and these results were superior to the results of treatment after peritoneal metastases had developed as recurrence. Also, prophylactic HIPEC improved survival with T3/T4 mucinous or signet ring colon cancers. A second-look has been shown to be effective in two published manuscripts. Unpublished data from MedStar Washington Cancer Institute also produced favorable date. Rectal cancer with peritoneal metastases may not be so effectively treated. There are both credits and debits of this proactive approach. Selection factors should be reviewed by the multidisciplinary team for individualized management of patients with or at high risk for peritoneal metastases.

关键词： peritoneal metastases carcinomatosis Local recurrence Hyperthermic perioperative chemotherapy Secondary prevention Proactive treatment Mucinous colon cancer Signet ring colon cancer

Hyperthermic intraperitoneal chemotherapy:Rationale and technique

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World Journal of Gastrointestinal Oncology 2010年第2期2卷 68-75页

作者： Santiago González-Moreno Luis A González-Bayón Gloria Ortega-Pérez peritoneal Surface Oncology program Department of Surgical OncologyCentro Oncológico MD Anderson International Espaa28033 MadridSpain

The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms,either primary or secondary to digestive or gynecologic *** intraperitoneal chemotherapy (HIPEC) delivered in the operating room once the cytoreductive surgical procedure is fi nalized,constitutes the most common form of administration of perioperative intraperitoneal *** may be complemented in some instances with early postoperative intraperitoneal chemotherapy (EPIC).HIPEC combines the pharmacokinetic advantage inherent to the intracavitary delivery of certain cytotoxic drugs,which results in regional dose intensification,with the direct cytotoxic effect of *** exhibits a selective cell-killing effect in malignant cells by itself,potentiates the cytotoxic effect of certain chemotherapy agents and enhances the tissue penetration of the administered *** chemotherapeutic agents employed in HIPEC need to have a cell cycle nonspecific mechanism of action and should ideally show a heat-synergistic cytotoxic *** of HIPEC requires an apparatus that heats and circulates the chemotherapeutic solution so that a stable temperature is maintained in the peritoneal cavity during the *** open abdomen (Coliseum) or closed abdomen technique may be used,with no signif icant differences in eff icacy proven to *** ic technical training and a solid knowledge of regional chemotherapy management are *** about safety of the procedure for operating room personnel are expected but are manageable if universal precautions and standard chemotherapy handling procedures are *** HIPEC drug regimens and dosages are currently in use.A tendency for concurrent intravenous chemotherapy administration (bidirectional chemotherapy,so-called "HIPEC plus") has been observed in rece

关键词： Hyperthermia Intracavitary chemotherapy peritoneal neoplasms peritoneal carcinomatosis Cytoreductive surgery

Intraperitoneal chemotherapy and its evolving role in management of gastric cancer with peritoneal metastases

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Chinese Journal of Cancer Research 2014年第1期26卷 1-3页

作者： Emel Canbay Yutaka Yonemura Bjorn Brucher Seung Hyuk Baik Paul H.Sugarbaker NPO HIPEC ISTANBUL Akkavak Sokak No:4/2NisantasiIstanbul 34365Turkey Ethica Incirli Hospital NPO to support peritoneal Dissemination Treatment 1-26 HarukimotomachiKishiwada CityOsaka 596-8522Japan NPO HIPEC ISTANBUL Akkavak Sokak No:4/2NisantasiIstanbul 34365Turkey NPO to support peritoneal Dissemination Treatment 1-26HarukimotomachiKishiwada CityOsaka 596-8522Japan Department of General Surgery Kusatsu General Hospital Department of General Surgery Kishiwada Tokushukai Hospital Department of peritoneal Surface Malignancy Bon Secours Cancer Institute Deparment of General Surgery Yonsei University College of Medicine Center for Gastrointestinal Malignancies Program in Peritoneal Surface OncologyMedStar Washington Hospital CenterNWPOB North Tower 3900 WashingtonDC 20010USA

Advanced gastric cancer （GC） has been recognized as lethal disease when peritoneal metastases （PM） *** is no standard treatment for advanced GC with *** 1980s,the therapeutic arena for these patients had remained stagnant,with no therapeutic approach having shown a survival gain in GC with ***,cytoreductive surgery （CRS） with peritonectomy procedures and intraperitoneal chemotherapy （IPC） promising new combined therapeutic approach to achieve disease control for GC with *** recent publications changed the GC with PM treatment landscape by providing an evidence that CRS and IPC led to prolongation in overall survival （OS）.This review will provide an overview of the evolving role of CRS and IPC in the management of advanced GC with PM in the current era.

关键词： Gastric cancer (GC) peritoneal carcinomatosis intraperitoneal and systemic induction chemotherapy cytoreductive surgery (CRS) hyperthermic intraperitoneal chemotherapy (IPC)

Gastric cancer: prevention and treatment of peritoneal metastases

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Journal of Cancer Metastasis and Treatment 2018年第1期4卷 88-103页

作者： Paul H.Sugarbaker Center for Gastrointestinal Malignancies Program in Peritoneal Surface OncologyMedStar Washington Hospital CenterWashingtonDC 20010USA

Gastric cancer is an aggressive malignancy that may metastasize through the bloodstream to the liver,through lymphatics to regi onal lymph n odes,or by pen etratio n of the perit on eal lining of the stomach to result in seed ing of the abdom inal and pelvis *** metastases are the most common mode of cancer *** to prevent or treat perit on eal metastases from adva need gastric can cer are prese nted in this manu *** world's literature,both recent and over the past three decades,was reviewed in order to identify publications that present information regarding gastric cancer peritoneal *** one dozen randomized controlled trials to test perioperative chemotherapy for prevention of peritoneal metastases were *** of the trials performed with regional chemotherapy during or shortly after gastrectomy were *** clinical data regarding the treatment of peritoneal metastases diagnosed at the time of primary can cer resecti on or in follow-up were *** nt in traperit on eal and systemic chemotherapy shows that some long-term survivors occur after these treatments were combined with cytoreductive surgery and *** treatments are advocated for primary gastric cancer with cytology positive for gastric cancer but no visible *** for gastric cancer should be combined with perioperative systemic and regional chemotherapy in order to maximally benefit patients with this disease by reducing the negative impact of peritoneal metastases on survival.

关键词： Hyperthermic intraperitoneal chemotherapy normothermic intraoperative intraperitoneal chemotherapy early postoperative intraperitoneal chemotherapy intraperitoneal chemotherapy gastric cancer peritoneal metastases carcinomatosis

Comprehensive treatment for the peritoneal metastasis from gastric cancer

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World Journal of Surgical Procedures 2015年第2期5卷 187-197页

作者： Yutaka Yonemura Emel Canbay Yoshio Endou Haruaki Ishibashi Akiyosi Mizumoto Yan Li Yang Liu Kazuyoshi Takeshita Masumi Ichinose Nobuyuki Takao Takuya Saitou Kousuke Noguchi Masamitu Hirano Oliver Glehen Bjorn Br?cher Paul H Sugarbaker NPO to Support peritoneal Surface Malignancy Treatment Department of Regional Cancer Therapies Peritoneal Surface Malignancy Center Kishiwada Tokusyukai Houspital Kusatsu General Hospital Department of Experimental Therapeutics Cancer Research Institute Kanazawa University Department of Surgery Wuhan University Dēpartement de Chirurgie Gēnerale Centre Hospitalier Lyon-Sud Hospices Civils de Lyon Surgical Oncology Department of Surgery T?bingen Comprehensive Cancer center University of T?bingen Center of Gastrointestinal Malignancies Program in Peritoneal Surface Malignancies Med Star Washington Hospital Center

Recently, a novel comprehensive treatment consisting of cytoreductive surgery(CRS) and perioperative chemotherapy(POC) was developed for the treatment of peritoneal metastasis(PM) with a curative intent. In the treatment, the macroscopic disease is completely removed by the peritonectomy techniques in combination with POC. This article reviews the results of the comprehensive treatment for PM from gastric cancer, and verifies the effects of CRS and POC, including neoadjuvant chemotherapy(NAC) and hyperthermic intraoperative intraperitoneal chemotherapy(HIPEC). Completeness of cytoreduction, peritoneal carcinomatosis index(PCI) less than the threshold levels after NAC,absence of ascites, cytologic status, pathologic response after NAC are the independent prognostic factors. Among these prognostic factors, PCI threshold level is the most valuable independent prognostic factor. After staging laparoscopy, patients with PM from gastric cancer are recommended to treat with NAC before CRS. After NAC, indication for CRS is determined by laparoscopy. The indications of the comprehensive treatment are patients with PCI less than the threshold levels, negative cytology, and responders after NAC. Patients satisfy these factors are the candidates for the CRS and HIPEC.

关键词： Gastric cancer Hyperthermic intraoperative intraperitoneal chemotherapy peritoneal metastasis Peritonectomy

Comparison of open and closed hyperthermic intraperitoneal chemotherapy: Results from the United States hyperthermic intraperitoneal chemotherapy collaborative

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World Journal of Gastrointestinal Oncology 2020年第7期12卷 756-767页

作者： Jennifer L Leiting Jordan M Cloyd Ahmed Ahmed Keith Fournier Andrew J Lee Sophie Dessureault Seth Felder Jula Veerapong Joel M Baumgartner Callisia Clarke Harveshp Mogal Charles A Staley Mohammad Y Zaidi Sameer H Patel Syed A Ahmad Ryan J Hendrix Laura Lambert Daniel E Abbott Courtney Pokrzywa Mustafa Raoof Christopher J LaRocca Fabian M Johnston Jonathan Greer Travis E Grotz Division of Hepatobiliary and Pancreas Surgery Mayo ClinicRochesterMN 55901United States Division of Surgical Oncology Department of SurgeryThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Surgical Oncology University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Gastrointestinal Oncology Moffitt Cancer CenterDepartment of Oncologic SciencesMorsani College of MedicineTampaFL 33612United States Division of Surgical Oncology Department of SurgeryUniversity of CaliforniaSan DiegoCA 92093United States Division of Surgical Oncology Department of SurgeryMedical College of WisconsinMilwaukeeWI 53226United States Division of Surgical Oncology Winship Cancer InstituteEmory UniversityAtlantaGA 30322United States Department of Surgery University of Cincinnati College of MedicineCincinnatiOH 45267United States Division of Surgical Oncology Department of SurgeryUniversity of Massachusetts Medical SchoolWorcesterMA 01655United States peritoneal Surface Malignancy program Section of Surgical Oncology Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUT 84112United States Division of Surgical Oncology Department of SurgeryUniversity of WisconsinMadisonWI 53792United States Christopher La Rocca Division of Surgical OncologyDepartment of SurgeryCity of Hope National Medical CenterDuarteCA 91010United States Department of Surgery Johns Hopkins UniversityBaltimoreMD 21287United States

BACKGROUND Cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)for peritoneal carcinomatosis can be performed in two ways:Open or closed abdominal *** To evaluate the impact of HIPEC method on post-operative and long-term survival *** Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative ***-operative,recurrence,and overall survival outcomes were compared between those who received open vs closed *** Of the 1812 patients undergoing curative-intent CRS and HIPEC,372(21%)patients underwent open HIPEC and 1440(79%)underwent closed *** was no difference in re-operation or severe complications between the two *** HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d *** multi-variable analysis,closed HIPEC technique was not a significant predictor for overall survival(hazards ratio:0.75,95%confidence interval:0.51-1.10,P=0.14)or recurrence-free survival(hazards ratio:1.39,95%confidence interval:1.00-1.93,P=0.05)in the entire *** findings remained consistent in the appendiceal and the colorectal *** In this multi-institutional analysis,the HIPEC method was not independently associated with relevant post-operative or long-term *** technique may be left to the discretion of the operating surgeon.

关键词： Mucinous appendiceal carcinoma Cytoreductive surgery Multi-institutional