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Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Cancer Therapy

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Special Issue Editors

Dr. Mao-Chih Hsieh

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Guest Editor

Dr. Hsin-Hsien Yu

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Guest Editor

1. Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
2. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11696, Taiwan
Interests: cytoreductive surgery and hyperthermic intraperitoneal chemotherapy; peritoneal surface malignancy; gastric cancer; minimally invasive surgery
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Special Issue Information

Dear Colleagues,

Cancer with peritoneal metastasis is a special form of metastasis and is difficult to treat, though many new drugs have been applied. For the past few decades, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have provided another treatment option. Many patients do not experience recurrence after CRS/HIPEC. However, it seems that CRS/HIPEC is only effective for some types of cancer and there exist conflicts regarding treatment results. Furthermore, there is still no global consensus regarding timing, temperature setting, hyperthermic duration or even drug choice. Genetic alteration may be a factor affecting the treatment results. Minimal invasive CRS/HIPEC is currently in development. Many trials are ongoing, with possible new findings on the horizon. This Special Issue welcomes reviews, original research articles of clinical works, new techniques, diagnostic tools, clinical trials and experimental studies.

Dr. Mao-Chih Hsieh
Dr. Hsin-Hsien Yu
Guest Editors

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Keywords

peritoneal metastasis
cytoreductive surgery
HIPEC
intraperitoneal chemotherapy
cancer therapy

Published Papers (2 papers)

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Research

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12 pages, 2034 KiB

Open AccessArticle

Safety and Effectiveness of Perioperative Hyperthermic Intraperitoneal Chemotherapy with Gemcitabine in Patients with Resected Pancreatic Ductal Adenocarcinoma: Clinical Trial EudraCT 2016-004298-41

by David Padilla-Valverde, Raquel Bodoque-Villar, Esther García-Santos, Susana Sanchez, Carmen Manzanares-Campillo, Marta Rodriguez, Lucia González, Alfonso Ambrós, Juana M. Cano, Maria Padilla-Marcote, Javier Redondo-Calvo, Jesus Martin and Leticia Serrano-Oviedo

Cancers 2024, 16(9), 1718; https://doi.org/10.3390/cancers16091718 - 28 Apr 2024

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Abstract

Background: Despite the improvement in therapies, pancreatic cancer represents one of the most cancer-related deaths. In our hypothesis, we propose that Hyperthermic Intraperitoneal Chemotherapy with gemcitabine after pancreatic cytoreductive surgery could reduce tumor progression by reducing residual neoplastic volume and residual pancreatic cancer stem cells. Materials and methods: A randomized trial involving 42 patients. All patients were diagnosed with pancreatic ductal adenocarcinoma. Group I: R0 resection. Group II. R0 resection and HIPEC with gemcitabine (120 mg/m² for 30 min). Effectiveness was measured with analysis of overall survival, disease-free survival, distant recurrence, locoregional recurrence, and measuring of pancreatic cancer stem cells (EpCAM⁺CXCR4⁺CD133⁺). Results: From 2017 to 2023, 63 patients were recruited for our clinical trial; 21 patients were included in each group, and 21 were excluded. Locoregional recurrence, p-value: 0.022, was lower in the experimental group. There were no significant differences between the two groups in hospital mortality, perioperative complications, or hospital costs. We found a significant decrease in pancreatic cancer stem cells in patients in the experimental group after treatment, p -value of 0.018. Conclusions: The use of HIPEC with gemcitabine after surgery in patients with resectable pancreatic ductal adenocarcinoma reduces locoregional recurrence and may be associated with a significant decrease in pancreatic cancer stem cells. Full article

(This article belongs to the Special Issue Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Cancer Therapy)

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Review

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15 pages, 1023 KiB

Open AccessReview

Current Status of Treatment among Patients with Appendiceal Tumors—Old Challenges and New Solutions?

by Katarzyna Chawrylak, Magdalena Leśniewska, Katarzyna Mielniczek, Katarzyna Sędłak, Zuzanna Pelc, Sebastian Kobiałka, Timothy M. Pawlik, Wojciech P. Polkowski and Karol Rawicz-Pruszyński

Cancers 2024, 16(5), 866; https://doi.org/10.3390/cancers16050866 - 21 Feb 2024

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Abstract

The 5th edition of the World Health Organization (WHO) classification of tumors of the digestive system distinguishes four categories of appendiceal tumors (ATs): serrated lesions and polyps, mucinous neoplasms, adenocarcinomas, and neuroendocrine neoplasms (NENs). The differential diagnosis of ATs can be challenging in medical practice, due to their rarity and lack of data from randomized controlled trials on a large, diverse group of patients. ATs are usually noted in specimens obtained during appendectomies due to clinical acute appendicitis. In the European population, most ATs (65%) occur over the age of 50 and among women (56.8%). According to histological type, 54.6% are neuroendocrine tumors (NETs); 26.8% cystic, mucinous, and serous neoplasms; and 18.6% adenocarcinoma not otherwise specified (NOS). On pathologic analysis, most AT findings are benign lesions or small NENs that do not require further therapeutic measures. The presence of appendiceal mucinous neoplasm (AMN) can lead to pseudomyxoma peritonei (PMP). While the multimodal treatment for abdominal malignancies has evolved over the past several decades, the clinical workup and treatment of ATs remain a challenge. Therefore, this review aims to describe the diagnostic possibilities, molecular-based diagnosis, staging, differences in the treatment process, and prognostic factors associated with ATs. Full article

(This article belongs to the Special Issue Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Cancer Therapy)

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