Feasibility of a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Program for Gastrointestinal and Gynecological Cancer Care in Newfoundland and Labrador
Simple Summary
Abstract
1. Introduction
1.1. Colorectal Cancer
1.2. Gastric Cancer
1.3. Pseudomyxoma Peritonei and Appendiceal Mucinous Neoplasms
1.4. Epithelial Ovarian Cancer
1.5. Centralization and Multidisciplinary Care
2. Materials and Methods
2.1. Gastrointestinal Population Retrospective Data Collection
2.2. Gynecological Population Retrospective Data Collection
3. Results
3.1. Gastrointestinal Population
3.2. Gynecological Population
3.3. Combined Population
4. Discussion
4.1. Centralization and Its Benefits
4.2. Population Estimates and Treatment Needs
4.3. Challenges and Considerations for Newfoundland and Labrador
4.4. Impact of a Unique Population
4.5. Combining Expertise for Better Outcomes
4.6. Identified Gaps and Recommendations
4.7. Developing a HIPEC Program
4.8. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
AMN | Appendiceal mucinous neoplasm |
BRCAm | BRCA mutated |
CHICG | Canadian HIPEC Collaborative Group |
CRC | Colorectal Cancer |
CRS | Cytoreductive Surgery |
EOC | Epithelial Ovarian Cancer |
GO | Gynecological Oncology |
HDGC | Hereditary diffuse gastric cancer |
HIPEC | Hyperthermic Intraperitoneal Chemotherapy |
HNPCC | Hereditary non-polyposis colorectal cancer |
IP | Intraperitoneal |
IV | Intravenous |
MMR | Mismatch repair |
NL | Newfoundland |
OR | Operation |
OS | Overall survival |
PC | Peritoneal carcinomatosis |
PCI | Peritoneal carcinomatosis Index |
PMP | Pseudomyxoma peritonei |
PSOGI | Peritoneal Surface Oncology Group |
References
- Auer, R.C.; Sivajohanathan, D.; Biagi, J.; Conner, J.; Kennedy, E.; May, T. Indications for Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery: A Clinical Practice Guideline. Curr. Oncol. 2020, 27, 146–154. [Google Scholar] [CrossRef] [PubMed]
- Quénet, F.; Elias, D.; Roca, L.; Goéré, D.; Ghouti, L.; Pocard, M.; Facy, O.; Arvieux, C.; Lorimier, G.; Pezet, D.; et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): A multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021, 22, 256–266. [Google Scholar] [CrossRef]
- Topgül, K.; Çetinkaya, M.B.; Arslan, N.Ç.; Gül, M.K.; Çan, M.; Gürsel, M.F.; Erdem, D.; Malazgirt, Z. Cytoreductive surgery (SRC) and hyperthermic intraperitoneal chemotherapy (HIPEC) for treatment of peritoneal carcinomatosis: Our initial experience and technical details. Turk. J. Surg. 2015, 31, 138–147. [Google Scholar] [CrossRef]
- Lheureux, S.; Gourley, C.; Vergote, I.; Oza, A.M. Epithelial ovarian cancer. Lancet 2019, 393, 1240–1253. [Google Scholar] [CrossRef] [PubMed]
- Sugarbaker, R.H.; Gianola, F.J.; Speyer, J.C.; Wesley, R.; Barofsky, I.; Meyers, C.E. Prospective, Randomized Trial of Intravenous Versus Intraperitoneal 5-Fluorouracil in Patients with Advanced Primary Colon or Rectal Cancer. Surgery 1985, 98, 414–422. Available online: https://europepmc.org/article/med/3898450 (accessed on 8 July 2024). [PubMed]
- Sugarbaker, P.H. Peritonectomy procedures. Ann. Surg. 1995, 221, 29–42. [Google Scholar] [CrossRef]
- Sugarbaker, P.H. Epithelial appendiceal neoplasms. Cancer J. 2009, 15, 225–235. [Google Scholar] [CrossRef]
- Verwaal, V.J.; van Ruth, S.; de Bree, E.; van Slooten, G.W.; van Tinteren, H.; Boot, H.; Zoetmulder, F.A. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J. Clin. Oncol. 2003, 21, 3737–3743. [Google Scholar] [CrossRef]
- Goéré, D.; Malka, D.; Tzanis, D.; Gava, V.; Boige, V.; Eveno, C.; Maggiori, L.; Dumont, F.; Ducreux, M.; Elias, D. Is there a possibility of a cure in patients with colorectal peritoneal carcinomatosis amenable to complete cytoreductive surgery and intraperitoneal chemotherapy? Ann. Surg. 2013, 257, 1065–1071. [Google Scholar] [CrossRef]
- Morris, D.L. Peritonectomy HIPEC-contemporary results, indications. Chin. J. Cancer Res. 2013, 25, 373–374. [Google Scholar] [CrossRef]
- Nassabein, R.; Younan, R.; Loungarath, R.; Mercier, F.; Dagbert, F.; Aubin, F.; Ayoub, J.P.; Tehfé, M. A Canadian single-centre experience with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for abdominal malignancies. Can. J. Surg. 2022, 65, E342–E351. [Google Scholar] [CrossRef] [PubMed]
- Van Driel, W.J.; Koole, S.N.; Sikorska, K.; Schagen van Leeuwen, J.H.; Schreuder, H.W.; Hermans, R.H.; Sonke, G.S. Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer. N. Engl. J. Med. 2018, 378, 230–240. [Google Scholar] [CrossRef]
- Lim, M.C.; Chang, S.J.; Park, B.; Yoo, H.J.; Yoo, C.W.; Nam, B.H.; Park, S.Y.; HIPEC for Ovarian Cancer Collaborators. Survival After Hyperthermic Intraperitoneal Chemotherapy and Primary or Interval Cytoreductive Surgery in Ovarian Cancer: A Randomized Clinical Trial. JAMA Surg. 2022, 157, 374. [Google Scholar] [CrossRef]
- Klaver, Y.L.B.; Simkens, L.H.J.; Lemmens, V.E.P.P.; Teerenstra, S.; Bleichrodt, R.P.; de Hingh, I.H.J.T.; Punt, C.J.A. Outcomes of colorectal cancer patients with peritoneal carcinomatosis treated with chemotherapy with and without targeted therapy. Eur. J. Surg. Oncol. 2012, 38, 617–623. [Google Scholar] [CrossRef]
- Franko, J.; Shi, Q.; Goldman, C.D.; Pockaj, B.B.; Nelson, G.D.; Goldberg, R.M.; Pitot, H.C.; Grothey, A.; Alberts, S.R.; Sargent, D.J. Treatment of colorectal peritoneal carcinomatosis with systemic chemotherapy: A pooled analysis of north central cancer treatment group phase III trials N9741 and N9841. J. Clin. Oncol. 2012, 30, 263–267. [Google Scholar] [CrossRef] [PubMed]
- Klaver, Y.L.B.; Lemmens, V.E.P.P.; Creemers, G.J.; Rutten, H.J.T.; Nienhuijs, S.W.; de Hingh, I.H.J.T. Population-based survival of patients with peritoneal carcinomatosis from colorectal origin in the era of increasing use of palliative chemotherapy. Ann. Oncol. 2011, 22, 2250–2256. [Google Scholar] [CrossRef]
- Brind’amour, A.; Dubé, P.; Tremblay, J.F.; Soucisse, M.L.; Mack, L.; Bouchard-Fortier, A.; McCart, J.A.; Govindarajan, A.; Dischof, D.; Hasse, E.; et al. Canadian Guidelines on the Management of Colorectal Peritoneal Metastases. Curr. Oncol. 2020, 27, 621–631. [Google Scholar] [CrossRef] [PubMed]
- Cao, C.; Yan, T.D.; Black, D.; Morris, D.L. A systematic review and meta-analysis of cytoreductive surgery with perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal origin. Ann. Surg. Oncol. 2009, 16, 2152–2165. [Google Scholar] [CrossRef] [PubMed]
- Elias, D.; Benizri, E.; Pocard, M.; Ducreux, M.; Boige, V.; Lasser, P. Treatment of synchronous peritoneal carcinomatosis and liver metastases from colorectal cancer. Eur. J. Surg. Oncol. 2006, 32, 632–636. [Google Scholar] [CrossRef]
- Sung, H.; Ferlay, J.; Siegel, R.L.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2021, 71, 209–249. [Google Scholar] [CrossRef]
- Gamboa, A.C.; Winer, J.H. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer. Cancers 2019, 11, 1662. [Google Scholar] [CrossRef]
- Khan, H.; Johnston, F.M. Current role for cytoreduction and HIPEC for gastric cancer with peritoneal disease. J. Surg. Oncol. 2022, 125, 1176–1182. [Google Scholar] [CrossRef] [PubMed]
- Gill, R.S.; Al-Adra, D.P.; Nagendran, J.; Campbell, S.; Shi, X.; Haase, E.; Schiller, D. Treatment of gastric cancer with peritoneal carcinomatosis by cytoreductive surgery and HIPEC: A systematic review of survival, mortality, and morbidity. J. Surg. Oncol. 2011, 104, 692–698. [Google Scholar] [CrossRef]
- Saito, H.; Kihara, K.; Kuroda, H.; Matsunaga, T.; Tatebe, S.; Ikeguchi, M. Surgical outcomes for gastric cancer patients with intraperitoneal free cancer cell, but no macroscopic peritoneal metastasis. J. Surg. Oncol. 2011, 104, 534–537. [Google Scholar] [CrossRef] [PubMed]
- Brucher, B.L.D.M.; Piso, P.; Verwaal, V.; Esquivel, J.; Derraco, M.; Yonemura, Y.; Gonzalez-Moreno, S.; Pelz, J.; Königarainer, A.; Ströhlein, M.; et al. Peritoneal carcinomatosis: Cytoreductive surgery and HIPEC—Overview and basics. Cancer Investig. 2012, 30, 209–224. [Google Scholar] [CrossRef]
- Bonnot, P.E.; Piessen, G.; Kepenekian, V.; Decullier, E.; Pocard, M.; Meunier, B.; Bereder, J.M.; Abboud, K.; Marchal, F.; Quenet, F.; et al. Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Metastases (CYTO-CHIP study): A Propensity Score Analysis. J. Clin. Oncol. 2019, 37, 2028–2040. [Google Scholar] [CrossRef]
- Badgwell, B.; Ikoma, N.; Murphy, M.B.; Wang, X.; Estrella, J.; Roy-Chowdhuri, S.; Das, P.; Minsky, B.D.; Lano, E.; Song, S.; et al. A Phase II Trial of Cytoreduction, Gastrectomy, and Hyperthermic Intraperitoneal Perfusion with Chemotherapy for Patients with Gastric Cancer and Carcinomatosis or Positive Cytology. Ann. Surg. Oncol. 2021, 28, 258–264. [Google Scholar] [CrossRef] [PubMed]
- Glehen, O.; Gilly, F.N.; Arvieux, C.; Cotte, E.; Boutitie, F.; Mansvelt, B.; Bereder, J.M.; Lorimier, G.; Quenet, F.; Elias, D.; et al. Peritoneal carcinomatosis from gastric cancer: A multi-institutional study of 159 patients treated by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy. Ann. Surg. Oncol. 2010, 17, 2370–2377. [Google Scholar] [CrossRef]
- Fujimoto, S.; Takahashi, M.; Mutou, T.; Kobayashi, K.; Toyosawa, T.; Isawa, E.; Sumida, M.; Ohkubo, H. Improved mortality rate of gastric carcinoma patients with peritoneal carcinomatosis treated with intraperitoneal hyperthermic chemoperfusion combined with surgery. Cancer 1997, 79, 884–891. [Google Scholar]
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Gastric Cancer. Version 2.2024. Available online: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1434 (accessed on 8 July 2024).
- Aziz, M.B.; Napoli, R.D. Hyperthermic Intraperitoneal Chemotherapy; Published online 31 July 2023; StatPearls: Treasure Island, FL, USA, 2023; Available online: https://www-ncbi-nlm-nih-gov.qe2a-proxy.mun.ca/books/NBK570563/ (accessed on 8 July 2024).
- Turner, K.M.; Hanna, N.N.; Zhu, Y.; Jain, A.; Kesmodel, S.B.; Switzer, R.A.; Taylor, L.M.; Alexander, H.R. Assessment of Neoadjuvant Chemotherapy on Operative Parameters and Outcome in Patients with Peritoneal Dissemination from High-Grade Appendiceal Cancer. Ann. Surg. Oncol. 2013, 20, 1068–1073. [Google Scholar] [CrossRef]
- Chua, T.C.; Moran, B.J.; Sugarbaker, P.H.; Levine, E.A.; Glehen, O.; Gilly, F.N.; Baratti, D.; Deraco, M.; Elias, D.; Sardi, A.; et al. Early- and Long-Term Outcome Data of Patients With Pseudomyxoma Peritonei From Appendiceal Origin Treated by a Strategy of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. J. Clin. Oncol. 2012, 30, 2449–2456. [Google Scholar] [CrossRef] [PubMed]
- Govaerts, K.; Lurvink, R.J.; De Hingh, I.H.J.T.; Speeten, K.V.; Villeneuve, L.; Kusamura, S.; Kepenekian, V.; Deraco, M.; Glehen, O.; Moran, B.J.; et al. Appendiceal tumours and pseudomyxoma peritonei: Literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment. Eur. J. Surg. Oncol. 2021, 47, 11–35. [Google Scholar] [CrossRef] [PubMed]
- Bollinger, D.J.; Wick, M.R.; Dehner, L.P.; Mills, S.E.; Swanson, P.E.; Clarke, R.E. Peritoneal malignant mesothelioma versus serous papillary adenocarcinoma. A histochemical and immunohistochemical comparison. Am. J. Surg. Pathol. 1989, 13, 659–670. [Google Scholar] [CrossRef]
- Desai, A.; Xu, J.; Aysola, K.; Qin, Y.; Okali, C.; Hariprasad, R.; Chinemerem, U.; Gates, C.; Reddy, A.; Danner, O.; et al. Epithelial ovarian cancer: An overview. World J. Transl. Med. 2014, 3, 1. [Google Scholar] [CrossRef]
- Lheureux, S.; Braunstein, M.; Oza, A.M. Epithelial ovarian cancer: Evolution of management in the era of precision medicine. CA Cancer J. Clin. 2019, 69, 280–304. [Google Scholar] [CrossRef]
- Vergote, I.; Tropé, C.G.; Amant, F.; Kristensen, G.; Ehlen, T.; Johnson, N.; Verheijen, R.H.M.; van der Burg, M.E.L.; Lacave, A.J.; Panici, P.B.; et al. Neoadjuvant Chemotherapy or Primary Surgery in Stage IIIC or IV Ovarian Cancer. N. Engl. J. Med. 2010, 363, 943–953. [Google Scholar] [CrossRef]
- Armstrong, D.K.; Bundy, B.; Wenzel, L.; Huang, H.Q.; Baergen, R.; Lele, S.; Copeland, L.J.; Walker, J.L.; Burger, R.A.; Gynecologic Oncology Group. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N. Engl. J. Med. 2006, 354, 34–43. [Google Scholar] [CrossRef]
- Filis, P.; Mauri, D.; Markozannes, G.; Tolia, M.; Filis, N.; Tsilidis, K. Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: A systematic review and meta-analysis of randomized trials. ESMO Open 2022, 7, 100586. [Google Scholar] [CrossRef] [PubMed]
- NCCN. Ovarian Cancer Continue Including Fallopian Tube Cancer and Primary Peritoneal Cancer Version 2.2024. In NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®); NCCN: Philadelphia, PA, USA, 2025. [Google Scholar]
- Bhatt, A.; Glehen, O.; Zivanovic, O.; Brennan, D.; Nadeau, C.; Van Driel, W.; Bakrin, N. The 2022 PSOGI international consensus on HIPEC regimens for peritoneal Malignancies: Epithelial ovarian cancer. Ann. Surg. Oncol. 2023, 30, 8115–8137. [Google Scholar] [CrossRef]
- Fagotti, A.; Costantini, B.; Fanfani, F.; Giannarelli, D.; De Iaco, P.; Chiantera, V.; Mandato, V.; Giorda, G.; Aletti, G.; Greggi, S.; et al. Hyperthermic Intraperitoneal Chemotherapy in Platinum-Sensitive Recurrent Ovarian Cancer: A Randomized Trial on Survival Evaluation (HORSE; MITO-18). J. Clin. Oncol. 2025, 43, 852–860. [Google Scholar] [CrossRef]
- Classe, J.M.; Meeus, P.; Hudry, D.; Wernert, R.; Guenet, F.; Marchal, F.; Houvenaeghel, G.; Bats, A.S.; Lecuru, F.; Ferron, G.; et al. Hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer (CHIPOR): A randomised, open-label, phase 3 trial. Lancet Oncol. 2024, 25, 1551–1562. [Google Scholar] [CrossRef]
- Koole, S.N.; Schouten, P.C.; Hauke, J.; Kluin, R.J.C.; Nederlof, P.; Richters, L.K.; Krebsbach, G.; Sikorska, K.; Alkemade, M.; Opdam, M.; et al. Effect of HIPEC according to HRD/BRCAwt genomic profile in stage III ovarian cancer: Results from the phase III OVHIPEC trial. Int. J. Cancer 2022, 151, 1394–1404. [Google Scholar] [CrossRef] [PubMed]
- Neveu, J.; Tremblay, E.; Mercier, F.; Garneau, S.; Cormier, B. Developing a hyperthermic intraperitoneal chemotherapy (HIPEC) gynecologic oncology program: A Canadian experience. Int. J. Gynecol. Cancer 2023, 33, 1957–1965. [Google Scholar] [CrossRef]
- Dubé, P.; Sideris, L.; Law, C.; Mack, L.; Hasse, E.; Giacomantonio, C.; Govindarajan, A.; Krzyzanowska, M.K.; Major, P.; McConnell, Y.; et al. Guidelines on the use of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal surface malignancy arising from colorectal or appendiceal neoplasms. Curr. Oncol. 2015, 22, e100–e112. [Google Scholar] [CrossRef]
- Balzano, G.; Guarneri, G.; Pecorelli, N.; Paiella, S.; Rancoita, P.M.V.; Bassi, C.; Falconi, M. Modelling centralization of pancreatic surgery in a nationwide analysis. Br. J. Surg. 2020, 107, 1510–1519. [Google Scholar] [CrossRef] [PubMed]
- Sheetz, K.H.; Dimick, J.B.; Nathan, H. Centralization of High-Risk Cancer Surgery Within Existing Hospital Systems. J. Clin. Oncol. 2019, 37, 3234–3242. [Google Scholar] [CrossRef]
- Vonlanthen, R.; Lodge, P.; Barkun, J.S.; Farges, O.; Rogiers, X.; Soreide, K.; Kehlet, H.; Reynolds, J.V.; Käser, S.A.; Naredi, P.; et al. Toward a Consensus on Centralization in Surgery. Ann. Surg. 2018, 268, 712–724. [Google Scholar] [CrossRef] [PubMed]
- el Asmar, A.; Delcourt, M.; Kamden, L.; Khaled, C.; Bohlok, A.; Moreau, M.; Sclafani, F.; Donckier, V.; Liberale, G. Prognostic Value of Preoperative Serological Biomarkers in Patients Undergoing Curative-Intent Cytoreductive Surgery for Colorectal Cancer Peritoneal Metastases. Ann. Surg. Oncol. 2023, 30, 1863–1869. [Google Scholar] [CrossRef]
- Hurry, M.; Hassan, S.; Seung, S.J.; Walton, R.N.; Elnoursi, A.; McGee, J.D. Real-World Treatment Patterns, Survival, and Costs for Ovarian Cancer in Canada: A Retrospective Cohort Study Using Provincial Administrative Data. J. Health Econ. Outcomes Res. 2021, 8, 114. [Google Scholar] [CrossRef]
- Solomon, D.; Leigh, N.; Bekhor, E.; Feferman, Y.; Dhorajiya, P.; Feingold, D.; Hofstedt, M.; Aycart, S.N.; Golas, B.J.; Sarpel, D.; et al. The role of molecular biomarkers in outcomes and patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases of colorectal origin. Surgeon 2021, 19, e379–e385. [Google Scholar] [CrossRef]
- Hulshof, E.C.; Lurvink, R.J.; Caserta, N.; de Hingh, I.H.J.T.; van Wezel, T.; Böhringer, S.; Swen, J.J.; Gelderblom, H.; Guchelaar, H.J.; Deenen, M.J. Identification of pharmacogenetic biomarkers for efficacy of cytoreductive surgery plus hyperthermic intraperitoneal mitomycin C in patients with colorectal peritoneal metastases. Eur. J. Surg. Oncol. 2020, 46, 1925–1931. [Google Scholar] [CrossRef] [PubMed]
- Koumpa, F.S.; Xylas, D.; Konopka, M.; Galea, D.; Veselkov, K.; Antoniou, A.; Mehta, A.; Mirnezami, R. Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research. Gastroenterol. Res. Pract. 2019, 2019, 5180895. [Google Scholar] [CrossRef]
- Chen, C.Y.; Wang, T.Y.; Liu, J.L.; Ou, Y.C.; Lee, L.W.; Hung, C.H.; Lee, C.P.; Lung, J. Association between cytokines and progression-free survival in ovarian cancer following CRS/HIPEC treatment. J. Ovarian Res. 2025, 18, 3. [Google Scholar] [CrossRef] [PubMed]
- Ducoulombier, S.; Golfier, F.; Colomban, O.; Benayoun, D.; Bolze, P.A.; Tod, M.; You, B. Modeling CA-125 during neoadjuvant chemotherapy for predicting optimal cytoreduction and relapse risk in ovarian cancer. Anticancer. Res. 2017, 37, 6879–6886. [Google Scholar] [CrossRef] [PubMed]
- Beagan, J.J.; Sluiter, N.R.; Bach, S.; Eijk, P.P.; Vlek, S.L.; Heideman, D.A.M.; Kusters, M.; Pegtel, D.M.; Kazemier, G.; van Grieken, N.C.T.; et al. Circulating Tumor DNA as a Preoperative Marker of Recurrence in Patients with Peritoneal Metastases of Colorectal Cancer: A Clinical Feasibility Study. J. Clin. Med. 2020, 9, 1738. [Google Scholar] [CrossRef]
- Zhai, G.; Zhou, J.; Woods, M.O.; Green, J.S.; Parfrey, P.; Rahman, P.; Green, R.C. Genetic structure of the Newfoundland and Labrador population: Founder effects modulate variability. Eur. J. Hum. Genet. 2016, 24, 1063–1070. [Google Scholar] [CrossRef]
- National Human Genome Research Institute. Founder Effect. Available online: https://www.genome.gov/genetics-glossary/Founder-Effect (accessed on 20 March 2025).
- Bear, J.C.; Nemec, T.F.; Kennedy, J.C.; Marshall, W.H.; Power, A.A.; Kolonel, V.M.; Burke, G.B. Persistent genetic isolation in outport Newfoundland. Am. J. Med. Genet. 1987, 27, 807–830. [Google Scholar] [CrossRef]
- Canadian Cancer Statistics Advisory Committee in collaboration with the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada. Canadian Cancer Statistics 2023; Canadian Cancer Society: Toronto, ON, Canada, 2023; ISSN 0835-2976. Available online: https://cc-arcc.ca/canadian-cancer-statistics-2023/ (accessed on 20 March 2025).
- Parfrey, P.S.; Dicks, E.; Parfrey, O.; McNicholas, P.J.; Noseworthy, H.; Woods, M.O.; Negriin, C.; Green, J. Evaluation of a population-based approach to familial colorectal cancer. Clin. Genet. 2017, 91, 672–682. [Google Scholar] [CrossRef]
- Green, R.C.; Green, J.S.; Buehler, S.K.; Robb, J.D.; Daftary, D.; Gallinger, S.; McLaughlin, J.R.; Parfrey, P.S.; Younghusband, H.B. Very high incidence of familial colorectal cancer in Newfoundland: A comparison with Ontario and 13 other population-based studies. Fam. Cancer 2007, 6, 53–62. [Google Scholar] [CrossRef]
- Woods, M.O.; Hyde, A.J.; Curtis, F.K.; Stuckless, S.; Green, J.S.; Pollett, A.F.; Robb, J.D.; Green, R.C.; Croitoru, M.E.; Careen, A.; et al. High frequency of hereditary colorectal cancer in Newfoundland likely involves wovel susceptibility genes. Clin. Cancer Res. 2005, 11, 6853–6861. [Google Scholar] [CrossRef]
- Fitzgerald, R.C.; Hardwick, R.; Huntsman, D.; Carneiro, F.; Guilford, P.; Blair, V.; Chung, D.C.; Norton, J.; Ragunath, K.; Van Krieken, J.H.; et al. Hereditary diffuse gastric cancer: Updated consensus guidelines for clinical management and directions for future research. J. Med. Genet. 2010, 47, 436–444. [Google Scholar] [CrossRef] [PubMed]
- Hebbard, P.C.; MacMillan, A.; Huntsman, D.; Kaurah, P.; Carneiro, F.; Wen, X.; Kwan, A.; Boone, D.; Bursey, F.; Fernandez, B.; et al. Prophylactic total gastrectomy (PTG) for hereditary diffuse gastric cancer (HDGC): The Newfoundland experience with 23 patients. Ann. Surg. Oncol. 2009, 16, 1890–1895. [Google Scholar] [CrossRef] [PubMed]
- Kaurah, P.; MacMillan, A.; Boyd, N.; Senz, J.; De Luca, A.; Chun, N.; Suriano, G.; Zaor, S.; Van Manen, L.; Gilpin, C.; et al. Founder and recurrent CDH1 mutations in families with hereditary diffuse gastric cancer. JAMA 2007, 297, 2360–2372. [Google Scholar] [CrossRef] [PubMed]
- Rebbeck, T.R.; Mitra, N.; Wan, F.; Sinilnikova, O.M.; Healey, S.; McGuffog, L.; Mazoyer, S.; Chenevix-Trench, G.; Easton, D.F.; Antoniou, A.A.; et al. Association of type and location of BRCA1 and BRCA2 mutations with risk of breast and ovarian cancer. J. Am. Med. Assoc. 2015, 313, 1347–1361. [Google Scholar] [CrossRef]
- Kuchenbaecker, K.B.; Hopper, J.L.; Barnes, D.R.; Phillips, K.A.; Mooij, T.M.; Roos-Blom, M.J.; Jervis, S.; van Leeuwen, F.E.; Milne, R.L.; Andrieu, N.; et al. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA 2017, 317, 2402–2416. [Google Scholar] [CrossRef]
- Roebothan, A.; Smith, K.N.; Seal, M.; Etchegary, H.; Dawson, L. Specialty Care and Counselling about Hereditary Cancer Risk Improves Adherence to Cancer Screening and Prevention in Newfoundland and Labrador Patients with BRCA1/2 Pathogenic Variants: A Population-Based Retrospective Cohort Study. Curr. Oncol. 2023, 30, 9367–9381. [Google Scholar] [CrossRef]
- Nikiforchin, A.; Sardi, A.; King, M.C.; Baron, E.; Lopez-Ramirez, F.; Falla-Zuniga, L.F.; Barakat, P.; Iugai, S.; Pawlikowski, K.; Nieroda, C.; et al. Collaborative expertise of gynecological and surgical oncologists in managing advanced epithelial ovarian cancer. Eur. J. Surg. Oncol. 2024, 50, 107948. [Google Scholar] [CrossRef]
Total Number of Eligible Patients (n) | 11 |
Median Age (years, range) | 61, 44–76 |
Primary Diagnosis and Histological Subtype (n (%)) | |
Colorectal | 7 (63.6%) |
Adenocarcinoma | 5 |
Mucinous Adenocarcinoma | 1 |
Goblet Cell Adenocarcinoma | 1 |
Gastric | 1 (9.1%) |
Adenocarcinoma | 1 |
Appendiceal | 3 (27.3%) |
LAMN | 1 |
Mucinous Adenocarcinoma | 1 |
Goblet Cell Adenocarcinoma | 1 |
Treatment Characteristics of Gastrointestinal Cases (n = 11) | n (%) |
---|---|
Primary Lesion Resected | |
Yes | 7 (63.6%) |
No | 4 (36.4%) |
Neoadjuvant Therapy | |
Yes | 3 (27.3%) |
No | 8 (72.7%) |
Adjuvant Therapy Prior to Referral | |
Yes | 5 (45.5%) |
No | 6 (54.5%) |
Treatment Site | |
Tertiary Cancer Centre | 7 (63.6%) |
Peripheral Centre | 4 (36.4%) |
Referred for CRS/HIPEC | |
Yes | 5 (45.5%) |
Refused | 2 (18.2%) |
No | 4 (36.4%) |
Received CRS/HIPEC | |
Yes | 4 (36.4%) |
No (wait and watch protocol) | 1 (9.1%) |
Total Number of Eligible Patients (n) | 20 |
Median Age (years, range) | 67.5, 48–84 |
Histological Subtype (n (%)) | |
High-Grade Serous | 16 (80%) |
Carcinosarcoma | 3 (15%) |
Clear Cell | 1 (5%) |
Stage (n (%)) | |
IIIB | 3 (15%) |
IIIC | 14 (70%) |
IV | 3 (15%) |
BRCA Mutation (n (% affected)) | 3 (15%) |
Treatment Characteristics of Gynecological Cases (n = 20) | n (%) |
---|---|
Extent of Surgical Debulking | |
Optimal | 9 (45%) |
Complete | 11 (55%) |
Timing of Debulking Surgery | |
Primary Debulking | 6 (30%) |
Interval Debulking | 14 (70%) |
Bowel Resection Required | |
Yes | 5 (25%) |
No | 15 (75%) |
Neoadjuvant Therapy | |
Yes | 14 (70%) |
No | 6 (30%) |
Adjuvant Therapy | |
Yes | 20 (100%) |
No | 0 (0%) |
Method of Adjuvant Chemotherapy | |
IV | 16 (80%) |
IP/IV | 4 (20%) |
Treatment Site | |
Tertiary Cancer Centre | 9 (45%) |
Peripheral Centre | 11 (55%) |
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Hickey, K.; Gill, S.; Breen, Z.; Harding, K.; Yaremko, H.; Mathieson, A.; Power, P.; Pace, D.; Neveu, J. Feasibility of a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Program for Gastrointestinal and Gynecological Cancer Care in Newfoundland and Labrador. Onco 2025, 5, 16. https://doi.org/10.3390/onco5020016
Hickey K, Gill S, Breen Z, Harding K, Yaremko H, Mathieson A, Power P, Pace D, Neveu J. Feasibility of a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Program for Gastrointestinal and Gynecological Cancer Care in Newfoundland and Labrador. Onco. 2025; 5(2):16. https://doi.org/10.3390/onco5020016
Chicago/Turabian StyleHickey, Kala, Stephanie Gill, Zoë Breen, Kaitlyn Harding, Hannah Yaremko, Alex Mathieson, Patti Power, David Pace, and Joannie Neveu. 2025. "Feasibility of a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Program for Gastrointestinal and Gynecological Cancer Care in Newfoundland and Labrador" Onco 5, no. 2: 16. https://doi.org/10.3390/onco5020016
APA StyleHickey, K., Gill, S., Breen, Z., Harding, K., Yaremko, H., Mathieson, A., Power, P., Pace, D., & Neveu, J. (2025). Feasibility of a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Program for Gastrointestinal and Gynecological Cancer Care in Newfoundland and Labrador. Onco, 5(2), 16. https://doi.org/10.3390/onco5020016