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Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Gastrointestinal Cancers: Current Updates and Perspectives

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 8442

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Special Issue Editors

Prof. Dr. Joseph Kim

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Guest Editor

Division of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY 40536, USA
Interests: surgical oncology; robotic surgery; pancreatic cancer; gastric cancer; HIPEC
Special Issues, Collections and Topics in MDPI journals

Dr. Prakash Pandalai

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Guest Editor

Division of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY 40536, USA
Interests: surgical oncology; HIPEC; pancreatic cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Edition is dedicated to heated intraperitoneal chemotherapy (HIPEC) in the setting of peritoneal carcinomatosis (PC). This is an important and timely topic, as the application of cytoreductive surgery (CRS) and HIPEC is increasing worldwide. As a clinical entity, PC results in significant morbidity and increased mortality in patients with advanced gastrointestinal malignancy. While data are scarce, it is estimated that up to 50% of patients will develop peritoneal-based recurrence following curative intent surgery for gastric, colorectal, and appendiceal cancer. While the historic 5-year survival for these patients is less than 20%, more recent studies have demonstrated that CRS/HIPEC in combination with modern systemic chemotherapy has resulted in a median overall survival of 40 months in select patients. Important to the discussion is the understanding that CRS/HIPEC consists of two distinct, but combined, surgical strategies with the aim to render patient’s disease free. With an ever-increasing list of indications (peritoneal mesothelioma, gastric cancer, colon cancer, appendiceal cancer, and primary peritoneal cancer), it seems critical to appreciate that biology is still king. While we often discuss PC as a final terminal pathway in many advanced gastrointestinal malignancies, we must recognize that variation in outcomes based on histology and biology are only now being investigated and considered as we attempt to provide a more personalized approach to patient-centered decision making. We hope to provide updates on the genomic landscape of PC, immunotherapy, advances in systemic therapy, surgery, and novel approaches in chemotherapeutics during HIPEC and drug delivery itself. Recent advances offer the promise of continued success in improving outcomes for patients with PC. We hope you will enjoy this Special Issue.

Prof. Joseph Kim
Prof. Prakash Pandalai
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Peritoneal Carcinomatosis
Gastrointestinal Cancer
Cytoreductive Surgery
HIPEC
Immunotherapy
PRODIGE
Organoid
Pseuodomyxoma Peritonei

Published Papers (4 papers)

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Research

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12 pages, 284 KiB

Open AccessArticle

Insulin Resistance Is Not Increased in Inflammatory Bowel Disease Patients but Is Related to Non-Alcoholic Fatty Liver Disease

by Marta Carrillo-Palau, Alejandro Hernández-Camba, Noemi Hernández Alvarez-Buylla, Laura Ramos, Inmaculada Alonso-Abreu, Anjara Hernández-Pérez, Milagros Vela, Laura Arranz, Manuel Hernández-Guerra, Miguel Á. González-Gay and Iván Ferraz-Amaro

J. Clin. Med. 2021, 10(14), 3062; https://doi.org/10.3390/jcm10143062 - 10 Jul 2021

Cited by 6 | Viewed by 1665

Abstract

Background. Insulin resistance (IR) has been linked to inflammatory states. The aim of this study was to determine whether IR is increased in a cohort of inflammatory bowel disease (IBD) patients with low disease activity. We additionally intended to establish which factors were the determinants of IR in this population, including the presence of nonalcoholic fatty liver disease (NAFLD). Methods. Cross-sectional study encompassing 151 IBD patients and 174 non-diabetic controls. Insulin and C-peptide serum levels and IR and beta cell function (%B) indices based on homoeostatic model assessment (HOMA2) were assessed in patients and controls. Liver stiffness as measured by transient elastography, and the presence of NAFLD detected via ultrasound were additionally assessed. A multivariable regression analysis was performed to evaluate the differences in IR indexes between patients and controls, and to determine which predictor factors were associated with IR in IBD patients. Results. Neither HOMA2-IR (beta coef. −0.26 {95%CI −0.64–0.13}, p = 0.19) nor HOMA2-%B (beta coef. 15 {95%CI −14–44}, p = 0.31) indexes differed between patients and controls after fully multivariable analysis. Among classic IR risk factors, obesity, abdominal circumference, and triglycerides significantly and positively correlated with IR indexes in IBD patients. However, most features related to IBD, such as disease patterns, disease activity, and inflammatory markers, were not associated with IR. The presence of NAFLD was independently and significantly associated with beta cell dysfunction in patients with IBD (HOMA2—B grade 4, 251 ± 40 vs. grade 1, 107 ± 37, p = <0.001). Conclusions. IR is not increased in IBD patients with low disease activity compared to controls. However, the presence of NAFLD favors the development of IR in patients with IBD. Full article

(This article belongs to the Special Issue Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Gastrointestinal Cancers: Current Updates and Perspectives)

Review

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9 pages, 1693 KiB

Open AccessReview

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Peritoneal Metastases: A Summary of Key Clinical Trials

by Kevin M. Turner, Mackenzie C. Morris, Davendra Sohal, Jeffrey J. Sussman, Gregory C. Wilson, Syed A. Ahmad and Sameer H. Patel

J. Clin. Med. 2022, 11(12), 3406; https://doi.org/10.3390/jcm11123406 - 14 Jun 2022

Cited by 2 | Viewed by 1996

Abstract

The peritoneal cavity is a common site of metastatic spread from colorectal cancer (CRC). Patients with peritoneal metastases (PM) often have aggressive underlying tumor biology and poor survival. While only a minority of patients with CRC have potentially resectable disease, the high overall incidence of CRC makes management of PM a common clinical problem. In this population, cytoreductive surgery (CRS)-hyperthermic intraperitoneal chemotherapy (HIPEC) is the only effective therapy for appropriately selected patients. In this narrative review, we summarize the existing literature on CRS-HIPEC in colorectal PM. Recent prospective clinical trials have shown conflicting evidence regarding the benefit of HIPEC perfusion in addition to CRS. Current strategies to prevent PM in those at high-risk have been shown to be ineffective. Herein we will provide a framework for clinicians to understand and apply these data to treat this complex disease presentation. Full article

(This article belongs to the Special Issue Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Gastrointestinal Cancers: Current Updates and Perspectives)

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22 pages, 728 KiB

Open AccessReview

Current Trends in Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Disease from Appendiceal and Colorectal Malignancies

by Megan M. Harper, Joseph Kim and Prakash K. Pandalai

J. Clin. Med. 2022, 11(10), 2840; https://doi.org/10.3390/jcm11102840 - 18 May 2022

Cited by 7 | Viewed by 3515

Abstract

Peritoneal carcinomatosis (PC) is a poor prognostic factor for all malignancies. This extent of metastatic disease progression remains difficult to treat with systemic therapies due to poor peritoneal vascularization resulting in limited drug delivery and penetration into tissues. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are surgical interventions that directly target peritoneal tumors and have improved outcomes for PC resulting from appendiceal and colorectal cancer (CRC). Despite these radical therapies, long-term survival remains infrequent, and recurrence is common. The reasons for these outcomes are multifactorial and signal the need for the continued development of novel therapeutics, techniques, and approaches to improve outcomes for these patients. Here, we review landmark historical studies that serve as the foundation for current recommendations, recent discoveries, clinical trials, active research, and areas of future interest in CRS/HIPEC to treat PC originating from appendiceal and colorectal malignancies. Full article

(This article belongs to the Special Issue Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Gastrointestinal Cancers: Current Updates and Perspectives)

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9 pages, 789 KiB

Open AccessReview

Treatment of Patients with Malignant Peritoneal Mesothelioma

by Claire Y. Li, Timothy Kennedy and Henry Richard Alexander

J. Clin. Med. 2022, 11(7), 1891; https://doi.org/10.3390/jcm11071891 - 29 Mar 2022

Cited by 4 | Viewed by 2380

Abstract

Malignant peritoneal mesothelioma is a rare malignancy arising from the serosa of the peritoneal cavity. It is diagnosed based on suspicious findings on cross sectional imaging and a tissue biopsy showing confirmatory histologic and immunohistochemical features. The disease is hallmarked by its propensity to progress mainly in the peritoneal cavity. In selected patients, surgical cytoreduction and hyperthermic intra-operative peritoneal chemotherapy has become the initial preferred treatment and is associated with provide prolonged in many patients. Systemic chemotherapy using a couplet of cisplatin or gemcitabine with pemetrexed has modest response rates and duration of response. Expression of PD-L1 has been demonstrated in peritoneal mesothelioma tumors and there has been significant interest in the use of check point blockade targeted against PD-L1 in this clinical setting. Future clinical research using a combination of check point blockade with surgical cytoreduction is a high clinical priority. Full article

(This article belongs to the Special Issue Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Gastrointestinal Cancers: Current Updates and Perspectives)

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