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Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer

Wim Ceelen (UGent) , Uwe Hesse (UGent) , Bernard de Hemptinne (UGent) and Piet Pattyn (UGent)
(2000) BRITISH JOURNAL OF SURGERY. 87(8). p.1006-1015
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Abstract
Background: Surgical treatment of intra-abdominal cancer is often followed by local recurrence. In a subgroup of patients, local recurrence is the sole site of disease, reflecting biologically low-grade malignancy. These patients might, therefore, benefit from local treatment. Recently, debulking surgery followed by hyperthermic chemoperfusion has been proposed in the treatment of locally advanced or recurrent intra-abdominal cancer. This paper reviews the rationale and assesses the currently accepted indications for and results of this novel treatment. Methods: A systematic web-based literature review was performed. Information was also retrieved from handbooks, congress abstracts and ongoing clinical trials. Results: A growing body of experimental evidence supports the use of hyperthermia combined with chemotherapy as an adjunct to cytoreductive surgery. Randomized clinical trials are available to support its use in the treatment and prevention of peritoneal carcinomatosis following resection of pathological tumour stage pT(3) or pT(4) gastric cancer; several other phase III trials are ongoing. Numerous phase I and II trials have reported good results for various other indications, with acceptable morbidity and mortality rates. Case mix, limited patient numbers and absence of a standardized technique are, however, a drawback in many of these series. Conclusion: For a subgroup of patients with peritoneal cancer without distant disease, debulking surgery followed by hyperthermic chemoperfusion may offer a chance of cure or palliation in this otherwise untreatable condition. This novel therapy should, however, be considered experimental until further results from ongoing phase In trials become available.
Keywords
WHOLE-BODY HYPERTHERMIA, DNA ADDUCT FORMATION, GYNECOLOGIC-ONCOLOGY-GROUP, INTERSTITIAL FLUID PRESSURE, POTENTIALLY CURATIVE RESECTION, TUMOR-NECROSIS-FACTOR, ISOLATED LIMB PERFUSION, PHASE-I TRIAL, PERITONEAL CARCINOMATOSIS, OVARIAN-CANCER

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Citation

Please use this url to cite or link to this publication:

Chicago
Ceelen, Wim, Uwe Hesse, Bernard de Hemptinne, and Piet Pattyn. 2000. “Hyperthermic Intraperitoneal Chemoperfusion in the Treatment of Locally Advanced Intra-abdominal Cancer.” British Journal of Surgery 87 (8): 1006–1015.
APA
Ceelen, Wim, Hesse, U., de Hemptinne, B., & Pattyn, P. (2000). Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer. BRITISH JOURNAL OF SURGERY, 87(8), 1006–1015.
Vancouver
1.
Ceelen W, Hesse U, de Hemptinne B, Pattyn P. Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer. BRITISH JOURNAL OF SURGERY. 2000;87(8):1006–15.
MLA
Ceelen, Wim, Uwe Hesse, Bernard de Hemptinne, et al. “Hyperthermic Intraperitoneal Chemoperfusion in the Treatment of Locally Advanced Intra-abdominal Cancer.” BRITISH JOURNAL OF SURGERY 87.8 (2000): 1006–1015. Print.
@article{172371,
  abstract     = {Background: Surgical treatment of intra-abdominal cancer is often followed by local recurrence. In a subgroup of patients, local recurrence is the sole site of disease, reflecting biologically low-grade malignancy. These patients might, therefore, benefit from local treatment. Recently, debulking surgery followed by hyperthermic chemoperfusion has been proposed in the treatment of locally advanced or recurrent intra-abdominal cancer. This paper reviews the rationale and assesses the currently accepted indications for and results of this novel treatment.
Methods: A systematic web-based literature review was performed. Information was also retrieved from handbooks, congress abstracts and ongoing clinical trials.
Results: A growing body of experimental evidence supports the use of hyperthermia combined with chemotherapy as an adjunct to cytoreductive surgery. Randomized clinical trials are available to support its use in the treatment and prevention of peritoneal carcinomatosis following resection of pathological tumour stage pT(3) or pT(4) gastric cancer; several other phase III trials are ongoing. Numerous phase I and II trials have reported good results for various other indications, with acceptable morbidity and mortality rates. Case mix, limited patient numbers and absence of a standardized technique are, however, a drawback in many of these series.
Conclusion: For a subgroup of patients with peritoneal cancer without distant disease, debulking surgery followed by hyperthermic chemoperfusion may offer a chance of cure or palliation in this otherwise untreatable condition. This novel therapy should, however, be considered experimental until further results from ongoing phase In trials become available.},
  author       = {Ceelen, Wim and Hesse, Uwe and de Hemptinne, Bernard and Pattyn, Piet},
  issn         = {0007-1323},
  journal      = {BRITISH JOURNAL OF SURGERY},
  keywords     = {WHOLE-BODY HYPERTHERMIA,DNA ADDUCT FORMATION,GYNECOLOGIC-ONCOLOGY-GROUP,INTERSTITIAL FLUID PRESSURE,POTENTIALLY CURATIVE RESECTION,TUMOR-NECROSIS-FACTOR,ISOLATED LIMB PERFUSION,PHASE-I TRIAL,PERITONEAL CARCINOMATOSIS,OVARIAN-CANCER},
  language     = {eng},
  number       = {8},
  pages        = {1006--1015},
  title        = {Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer},
  url          = {http://dx.doi.org/10.1046/j.1365-2168.2000.01538.x},
  volume       = {87},
  year         = {2000},
}

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