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[PMID]:27739318
[Au] Autor:Trnka J; Spacek M; Sírová V; Mitás P; Hodková G; Kubinyi J; Spunda R; Lindner J
[Ti] Título:[Hyperthermic Isolated Limb Perfusion Combined with Tasonermin - a Perfusion Leakage Monitoring Technique].
[Ti] Título:Hypertermická izolovaná perfuze koncetin v kombinaci s tasonerminem - technika monitorování úniku perfuzátu..
[So] Source:Klin Onkol;29(5):375-379, 2016.
[Is] ISSN:0862-495X
[Cp] País de publicação:Czech Republic
[La] Idioma:cze
[Ab] Resumo:BACKGROUND: Hyperthermic isolated limb perfusion is used to treat irresectable extremity malignancies. It is based on the following principle - the perfusion of the extremity is isolated from systemic circulation and connected to an extra-corporal circuit via which a very high concentration of a chemotherapeutic agent is administered into the blood compartment of the extremity. In some cases, treatment efficiency can be improved using tasonermin (a TNF-α agent). By itself, tasonermin can cause severe health complications in patients if leakage into systemic circulation results in a level that exceeds the maximally tolerated dose. Therefore, it is important to monitor for leakage during the whole operation. METHOD: Leakage monitoring was performed by a nuclear medicine method based on the measurement of activity of a gamma-emitting radiotracer detected by a scintillation probe located over the heart. An amount of radiotracer that resulted in a basal level of measured signal was first administered into the systemic circuit followed by the administration of a second, one order of magnitude higher amount of radiotracer into the perfusion circuit. Leakage, when it occurred, increased the count rate detected over the heart, and the mathematical relation between leakage level and count rate increase was derived. RESULTS: In our department, the method was tested and optimized during isolated limb perfusion without using a TNF-α agent. Then, accreditation for the use of TNF-α was granted. Since then, the method has been used to monitor leakage in all cases of isolated limb perfusion with TNF-α. All isolated limb perfusion operations with TNF-α passed without complications. The radiation burden was almost negligible for both the patient and medical staff. CONCLUSION: The method described in this report represents a reliable method for perfusion leakage monitoring when using TNF-α in our department.Key words: perfusion - isolated limb - TNF-α - leakage - monitoring - nuclear medicine - radiopharmaceuticalsThe authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 16. 6. 2016Accepted: 21. 6. 2016.
[Mh] Termos MeSH primário: Quimioterapia do Câncer por Perfusão Regional
Extravasamento de Materiais Terapêuticos e Diagnósticos/diagnóstico por imagem
Extremidades/diagnóstico por imagem
Hipotermia Induzida
Neoplasias/diagnóstico por imagem
Fator de Necrose Tumoral alfa/metabolismo
[Mh] Termos MeSH secundário: Antineoplásicos/uso terapêutico
Terapia Combinada
Extravasamento de Materiais Terapêuticos e Diagnósticos/metabolismo
Extremidades/patologia
Seres Humanos
Neoplasias/patologia
Neoplasias/terapia
Prognóstico
Cintilografia
Compostos Radiofarmacêuticos/metabolismo
Fator de Necrose Tumoral alfa/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Radiopharmaceuticals); 0 (Tumor Necrosis Factor-alpha)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171205
[Lr] Data última revisão:
171205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE


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[PMID]:29183538
[Au] Autor:Takeshita K; Liu Y; Ishibashi H; Yonemura Y
[Ti] Título:Laparoscopic Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosisfrom Gastric Cancer: Its Beneficial Effects on Reduction and Exact Evaluation of the Peritoneal Cancer Index.
[So] Source:Am Surg;83(11):1315-1320, 2017 Nov 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We assessed whether the laparoscopic hyperthermic intraperitoneal chemotherapy (L-HIPEC) + neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) could reduce the peritoneal cancer index (PCI; which is defined by Sugerbaker) and improve the possibility to obtain a complete cytoreductive surgery (CRS with peritonectomy; basically according to the Sugerbaker's procedure). After L-HIPEC + NIPS, the PCI score was decreased in 89.5 per cent of patients, and the average score was significantly reduced. The average PCI reduction of improved PCI cases was 10.2 ± 8.4. The hypothetical cut-off was at a PCI score of six with significant higher possibility of CRS completeness. Twelve patients had high-PCI (PCI > 6), and six of them (50.0%) were converted to low-PCI (PCI ≦ 6) and got a complete CRS. There was a significant relationship between post-PCI (PCI after L-HIPEC + NIPS) and CRS completeness; however, pre-PCI (PCI before L-HIPEC + NIPS) value was not a relevant factor. The high-PCI and increased PCI even after L-HIPEC + NIPS (deteriorated-PCI) were suggested as important risk factors for surgical completeness. Neither pre- nor postcytological results had a significant relationship between CRS completeness. However, the deteriorated cytological class was considered as a risk factor for CRS completeness. The second-look laparoscopy would be recommended for the better selection of the patients who can receive benefits by this extensive surgery.
[Mh] Termos MeSH primário: Quimioterapia do Câncer por Perfusão Regional/métodos
Procedimentos Cirúrgicos de Citorredução/métodos
Hipertermia Induzida/métodos
Laparoscopia/métodos
Neoplasias Peritoneais/terapia
[Mh] Termos MeSH secundário: Terapia Combinada
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Primárias Múltiplas/terapia
Segunda Neoplasia Primária/terapia
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE


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[PMID]:28991079
[Au] Autor:Mehta A; Mittal R; Chandrakumaran K; Carr N; Dayal S; Mohamed F; Moran B; Cecil T
[Ad] Endereço:Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Hampshire Hospitals National Health Service Foundation Trust, Basingstoke, Hampshire, United Kingdom.
[Ti] Título:Peritoneal Involvement Is More Common Than Nodal Involvement in Patients With High-Grade Appendix Tumors Who Are Undergoing Prophylactic Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.
[So] Source:Dis Colon Rectum;60(11):1155-1161, 2017 Nov.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Right hemicolectomy is routinely recommended in patients with histologic findings of high-grade appendix tumors after appendicectomy. Undetected peritoneal disease may be encountered at surgery. In high-grade appendix tumors with disease detected radiologically, complete cytoreduction may not be possible and outcomes poor. For these reasons, we adopted a policy of prophylactic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. OBJECTIVE: The purpose of this study was to quantify the rates of peritoneal and nodal metastatic disease in patients with high-grade appendix tumors without obvious metastatic disease and to report the long-term outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in these patients. DESIGN: Data regarding peritoneal and nodal metastatic disease were extracted from surgical and histologic records. SETTINGS: The study was conducted at a high-volume tertiary referral center for peritoneal malignancy. PATIENTS: Patients referred with histologically high-grade appendix tumors at appendicectomy, without detectable metastatic spread, between January 1994 and September 2016 were included MAIN OUTCOME MEASURES:: A total of 62 patients with high-grade pathology at appendicectomy, without clinical or radiological peritoneal disease, underwent complete cytoreduction with hyperthermic intraperitoneal chemotherapy. RESULTS: Thirty-five (57%) of 62 patients had peritoneal disease (median peritoneal cancer index 5 (range, 1-28)). Eleven (31%) of 35 had microscopic peritoneal disease. Overall, 23 (37%) of 62 had peritoneal disease beyond the confines of a standard right hemicolectomy. Nine (15%) of 62 had nodal involvement. Mean overall and disease-free survival were 110.9 (95% CI, 94.8-127.0 mo) and 102.1 months (95% CI, 84.3-119.9 mo), with 5-year overall and disease-free survival of 83.2% and 76.0%. LIMITATIONS: The retrospective nature limits the interpretation of these results. CONCLUSIONS: Complete cytoreduction was achieved in all of the patients, with excellent long-term survival. The incidence of peritoneal spread (57%) compared with nodal involvement (15%) supports cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as definitive treatment rather than prophylaxis in patients with high-grade appendix tumors, even without radiologically detectable disease. High-grade appendix tumors benefit from early aggressive operative management to deal with potential peritoneal and nodal spread and should be considered for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. See Video Abstract at http://links.lww.com/DCR/A360.
[Mh] Termos MeSH primário: Adenocarcinoma/secundário
Antineoplásicos/administração & dosagem
Neoplasias do Apêndice/patologia
Quimioterapia do Câncer por Perfusão Regional
Procedimentos Cirúrgicos de Citorredução
Hipertermia Induzida
Neoplasias Peritoneais/secundário
[Mh] Termos MeSH secundário: Adenocarcinoma/diagnóstico
Adenocarcinoma/mortalidade
Adenocarcinoma/prevenção & controle
Adulto
Idoso
Antineoplásicos/uso terapêutico
Apendicectomia
Neoplasias do Apêndice/mortalidade
Neoplasias do Apêndice/cirurgia
Quimioterapia do Câncer por Perfusão Regional/métodos
Colectomia
Terapia Combinada
Procedimentos Cirúrgicos de Citorredução/métodos
Feminino
Seguimentos
Seres Humanos
Hipertermia Induzida/métodos
Metástase Linfática
Masculino
Meia-Idade
Gradação de Tumores
Neoplasias Peritoneais/diagnóstico
Neoplasias Peritoneais/mortalidade
Neoplasias Peritoneais/prevenção & controle
Estudos Retrospectivos
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000869


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[PMID]:28918185
[Au] Autor:Huis In 't Veld EA; Grünhagen DJ; Verhoef C; Smith HG; van Akkooi ACJ; Jones R; van Coevorden F; Hayes AJ; van Houdt WJ
[Ad] Endereço:Sarcoma Unit, Department of Surgery, Royal Marsden Hospital, London, United Kingdom; Department of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
[Ti] Título:Isolated limb perfusion for locally advanced angiosarcoma in extremities: A multi-centre study.
[So] Source:Eur J Cancer;85:114-121, 2017 Nov.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Angiosarcomas are rare and aggressive soft-tissue sarcomas. The only potential curative treatment is complete surgical excision. This study reports the outcome of isolated limb perfusion (ILP) with high-dose melphalan and tumour necrosis factor α for locally advanced angiosarcoma. MATERIAL AND METHODS: All patients who underwent an ILP for angiosarcomas between 1991 and 2016 in three tertiary referral centres were identified from prospectively maintained databases. RESULTS: A total of 39 patients were included, with a median follow-up of 18 months (interquartile range 6.1-60.8). Of these patients, 23 (58.9%) patients had a complete response (CR) after ILP, 10 (25.6%) had a partial response, 4 (10.3%) had stable disease and 2 (5.1%) patients had progressive disease immediately after ILP. A total of 22 patients developed local progression (56.4%), whereas nine (23.1%) developed distant metastases. The patients with CR had a significantly prolonged median local progression-free survival (PFS) (15.4 versus 7.3 months, p = 0.015) when compared with non-CR patients, and a trend towards better median overall survival (81.2 versus 14.5 months, p = 0.054). Six patients underwent multiple ILPs, whereby the CR rate of the first, second and third ILPs were 60%, 80% and 67%, respectively. Thirteen (33.3%) patients needed further surgical intervention, consisting of resection in eight patients (20.5%) and amputation in five patients (12.8%). CONCLUSION: ILP is an effective treatment option for patients with locally advanced angiosarcoma in the extremities, resulting in a high number of CRs, a high limb salvage rate and prolonged local PFS.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimioterapia do Câncer por Perfusão Regional/métodos
Extremidades/irrigação sanguínea
Hemangiossarcoma/irrigação sanguínea
Hemangiossarcoma/terapia
Melfalan/administração & dosagem
Neoplasias de Tecidos Moles/irrigação sanguínea
Neoplasias de Tecidos Moles/terapia
Fator de Necrose Tumoral alfa/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Amputação
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Quimioterapia do Câncer por Perfusão Regional/efeitos adversos
Quimioterapia do Câncer por Perfusão Regional/mortalidade
Bases de Dados Factuais
Progressão da Doença
Intervalo Livre de Doença
Extremidades/patologia
Feminino
Hemangiossarcoma/mortalidade
Hemangiossarcoma/secundário
Seres Humanos
Estimativa de Kaplan-Meier
Salvamento de Membro
Londres
Masculino
Melfalan/efeitos adversos
Meia-Idade
Países Baixos
Modelos de Riscos Proporcionais
Fluxo Sanguíneo Regional
Retratamento
Estudos Retrospectivos
Fatores de Risco
Neoplasias de Tecidos Moles/mortalidade
Neoplasias de Tecidos Moles/patologia
Fatores de Tempo
Resultado do Tratamento
Fator de Necrose Tumoral alfa/efeitos adversos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Tumor Necrosis Factor-alpha); Q41OR9510P (Melphalan)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE


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[PMID]:28688635
[Au] Autor:Guadagni S; Fiorentini G; Clementi M; Palumbo G; Chiominto A; Cappelli S; Masedu F; Valenti M
[Ad] Endereço:Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy. Electronic address: stefano.guadagni@univaq.it.
[Ti] Título:Melphalan hypoxic perfusion with hemofiltration for melanoma locoregional metastases in the pelvis.
[So] Source:J Surg Res;215:114-124, 2017 Jul.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: For patients with melanoma metastases in the pelvic and groin regions, the median survival time (MST) was 8 mo with old treatments, whereas today is approximately 20 mo with new target therapy and novel immunotherapy. Unfortunately, approximately 30% of patients are nonresponsive to these new drugs. MATERIALS AND METHODS: Thirty-six patients, previously progressing after standard treatments, collectively received 146 melphalan (30 mg/m ) hypoxic pelvic perfusions with hemofiltration, in association with palliative excision in most cases. RESULTS: The median follow-up time was 15 mo. Among 36 patients, three patients were alive without evidence of disease after 62, 95, and 118 mo, respectively. Thirty-three patients died of melanoma. The overall MST was 15 mo. The 5-y survival rate was 8%. The MST was 37 mo for stage IIIB; 19 mo for stage IIIC; and 6 mo for stage IV. The MST was 11 mo for patients with ≥1 mitosis per mm and 20 mo for patients with <1 mitosis per mm ; 17 mo for patients who received excision and 7 mo for patients who did not receive excision; and 19.5 mo for patients who received >2 treatments and 7.5 mo for patients who received ≤2 treatments. CONCLUSIONS: Pelvic/inguinal perfusion is a safe and feasible treatment for patients with advanced melanoma. Further studies are necessary to establish if it may play a role in patients who fail current systemic therapies.
[Mh] Termos MeSH primário: Antineoplásicos Alquilantes/uso terapêutico
Quimioterapia do Câncer por Perfusão Regional/métodos
Hemofiltração
Melanoma/secundário
Melfalan/uso terapêutico
Neoplasias Pélvicas/secundário
Neoplasias Cutâneas/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Terapia Combinada
Feminino
Seguimentos
Seres Humanos
Hipóxia
Masculino
Melanoma/mortalidade
Melanoma/terapia
Meia-Idade
Neoplasias Pélvicas/mortalidade
Neoplasias Pélvicas/terapia
Estudos Prospectivos
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); Q41OR9510P (Melphalan)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE


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[PMID]:28637567
[Au] Autor:Hinkle NM; Botta V; Sharpe JP; Dickson P; Deneve J; Munene G
[Ti] Título:The Impact of Early Recurrence on Quality of Life after Cytoreduction with HIPEC.
[So] Source:Am Surg;83(6):633-639, 2017 Jun 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Improved oncological outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC. This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and postoperatively at 2 weeks, and 1, 3, 6, and 12 months. The Functional Assessment of Cancer Therapy-Colorectal instrument was used to determine changes in QoL after CRS/HIPEC and the impact of early recurrence (<12 months) on QoL. Thirty-six patients underwent CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18 and the completeness of cytoreduction-0/1 rate was 97.2 per cent. Postoperative major morbidity was 16.7 per cent with one perioperative death. Disease-free survival was 12.6 months in patients with high-grade tumors versus 31.0 months in those with low-grade tumors (P = 0.03). QoL decreased postoperatively and improved to baseline in six months. Patients with early recurrence had a decrease in global QoL compared with preoperative QoL at 6 (P < 0.03) and 12 months (P < 0.05). This correlation was not found in patients who had not recurred. Patients who undergo CRS/HIPEC have a decrease in QoL that plateaus in 3 to 6 months. Early recurrence adversely impacts QoL at 6 and 12 months. This study emphasizes the importance of patient selection for CRS/HIPEC. The expected QoL trajectory in patients at risk for early recurrence must be carefully weighed against the potential oncological benefit of CRS/HIPEC.
[Mh] Termos MeSH primário: Quimioterapia do Câncer por Perfusão Regional
Procedimentos Cirúrgicos de Citorredução
Hipertermia Induzida
Recidiva Local de Neoplasia/terapia
Neoplasias Peritoneais/terapia
Qualidade de Vida
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Procedimentos Cirúrgicos de Citorredução/métodos
Feminino
Seguimentos
Hospitais Universitários
Seres Humanos
Hipertermia Induzida/métodos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Recidiva Local de Neoplasia/mortalidade
Neoplasias Peritoneais/mortalidade
Estudos Prospectivos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE


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[PMID]:28628712
[Au] Autor:Magge D; Ramalingam L; Shuai Y; Edwards RP; Pingpank JF; Ahrendt SS; Holtzman MP; Zeh HJ; Bartlett DL; Choudry HA
[Ad] Endereço:Division of Surgical Oncology, Koch Regional Perfusion Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
[Ti] Título:Hyperthermic intraperitoneal chemoperfusion as a component of multimodality therapy for ovarian and primary peritoneal cancer.
[So] Source:J Surg Oncol;116(3):320-328, 2017 Sep.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: The role of hyperthermic intraperitoneal chemoperfusion (HIPEC) in the multimodality treatment of ovarian peritoneal metastases (OPM) and primary peritoneal cancer (PPC) remains controversial. We hypothesized that cytoreductive surgery (CRS) and HIPEC would provide meaningful survival benefit without excessive morbidity. METHODS: We reviewed clinicopathologic and perioperative data following 96 CRS-HIPEC procedures for primary or recurrent OPM and PPC. Kaplan-Meier survival curves and multivariate Cox-regression models identified prognostic factors affecting oncologic outcomes. RESULTS: CRS-HIPEC was mostly performed for recurrent disease (56.3%) and high-grade serous carcinoma (72.9%). Platinum-based systemic chemotherapy was administered to 89.5% of patients, with 75.5% having platinum-sensitive disease at CRS-HIPEC. Complete macroscopic resection was achieved in 70.8% of patients. Clavien-Dindo grade 3/4 morbidity occurred in 23.4% of patients; three patients died within 60-days postoperatively. Median overall survival from diagnosis of peritoneal metastases and CRS-HIPEC was 78 and 38 months, respectively. Completeness of cytoreduction, pathologic subtype, and 30-day morbidity were independent predictors of survival in multiple regression analysis. CONCLUSIONS: Our study demonstrates promising survival data and supports the role of HIPEC in the multimodality treatment algorithm for primary or recurrent OPM and PPC. However definite indications and timing of HIPEC need to be clarified by prospective studies.
[Mh] Termos MeSH primário: Carcinoma/terapia
Quimioterapia do Câncer por Perfusão Regional
Procedimentos Cirúrgicos de Citorredução
Hipertermia Induzida
Neoplasias Ovarianas/terapia
Neoplasias Peritoneais/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antineoplásicos/administração & dosagem
Carcinoma/mortalidade
Carcinoma/secundário
Estudos de Coortes
Terapia Combinada
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Meia-Idade
Estadiamento de Neoplasias
Neoplasias Ovarianas/mortalidade
Neoplasias Ovarianas/patologia
Neoplasias Peritoneais/mortalidade
Neoplasias Peritoneais/secundário
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24666


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[PMID]:28624046
[Au] Autor:Li KY; Mokdad AA; Minter RM; Mansour JC; Choti MA; Augustine MM; Polanco PM
[Ad] Endereço:Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
[Ti] Título:Failure to rescue following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
[So] Source:J Surg Res;214:209-215, 2017 Jun 15.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) can significantly improve the survival in selected patients with peritoneal carcinomatosis. This study aims to identify perioperative patient characteristics predictive of failure to rescue (FTR), mortality following postoperative complications from CRS/HIPEC. METHODS: Patients suffering a complication following CRS/HIPEC between 2005 and 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program data set. FTR was defined as 30-d mortality in the setting of a complication. Patients who suffered FTR were compared against those who survived a complication (non-FTR). Predictors of FTR were identified using a multivariable logistic regression model. RESULTS: A total of 915 eligible CRS/HIPEC cases were identified. In all, 382 patients (42%) developed ≥1 postoperative complication, and 88 patients (10%) suffered ≥1 major complication. Seventeen patients died following a complication, amounting to an FTR rate of 4%. FTR patients were more likely than non-FTR patients to have dependent functional status (18% versus 2%, P = 0.01), have American Society of Anesthesiologists (ASA) class 4 status (29% versus 8%, P = 0.01), develop ≥3 complications (65% versus 24%, P < 0.01), and suffer a major complication (94% versus 20%, P < 0.01). The following were independently associated with FTR: ASA class 4 (odds ratio [OR]: 13.4, 95% confidence interval [CI], 1.2-146.8) and major complications (OR: 66.0, 95% CI, 8.4-516.6). CONCLUSIONS: ASA class 4, major morbidity, and likely dependent functional status are independent predictors of FTR following CRS/HIPEC to treat peritoneal carcinomatosis. Therefore, ASA class 4 and dependent functional status should be considered as contraindications for CRS/HIPEC and only offered in highly selective cases.
[Mh] Termos MeSH primário: Quimioterapia do Câncer por Perfusão Regional
Procedimentos Cirúrgicos de Citorredução
Falha da Terapia de Resgate/estatística & dados numéricos
Hipertermia Induzida
Neoplasias Peritoneais/terapia
Complicações Pós-Operatórias/mortalidade
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Terapia Combinada
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Neoplasias Peritoneais/mortalidade
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Índice de Gravidade de Doença
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE


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[PMID]:28622839
[Au] Autor:Gabriel E; Singla S; Kim M; Fisher D; Powers C; Visioni A; Attwood K; Skitzki J
[Ad] Endereço:Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
[Ti] Título:Water lavage as an adjunct to cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
[So] Source:Am J Surg;214(3):462-467, 2017 Sep.
[Is] ISSN:1879-1883
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Water lavage (WL) during gastrointestinal cancer surgery has osmotically mediated lytic effects on tumor cells. We investigated the safety and efficacy of WL with CRS-HIPEC. METHODS: This is a retrospective review, 1/2003-7/2014, of a single institution experience with CRS-HIPEC comparing patients who had WL (WL+) to those who did not (WL-). RESULTS: Of 157 CRS-HIPECs, 16 (10.2%) were WL+. WL+ had more PCI scores >20 compared to WL- (56.3% vs 19.4%, respectively, p = 0.003); however, the completeness of cytoreduction (CC) was similar. There were no differences in hospital length of stay or post-operative complications. The average POD 1 sodium (Na) level was statistically lower in the WL+ group (133.6 ± 2.5 vs 135.5 ± 3.2 mEq/L, p = 0.023); however, the average Na at discharge for each group was 140 mEq/L. There were no differences in 3-year OS (3WL+:0.63 vs WL-:0.68, p = 0.97) or RFS (WL+:0.32 vs WL-:0.39, p = 0.47). A subset analysis for patients with PCI >20 showed no difference between groups. CONCLUSIONS: WL offers a low cost, safe and theoretically efficacious method of tumor cell lysis for peritoneal malignancy.
[Mh] Termos MeSH primário: Quimioterapia do Câncer por Perfusão Regional
Procedimentos Cirúrgicos de Citorredução
Hipertermia Induzida
Neoplasias Peritoneais/tratamento farmacológico
Neoplasias Peritoneais/cirurgia
[Mh] Termos MeSH secundário: Terapia Combinada
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Irrigação Terapêutica/métodos
Água
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
059QF0KO0R (Water)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170618
[St] Status:MEDLINE


  10 / 3204 MEDLINE  
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[PMID]:28601307
[Au] Autor:Stamatiou D; Ioannou CV; Kontopodis N; Michelakis D; Perisinakis K; Lasithiotakis K; Zoras O
[Ad] Endereço:Department of Surgical Oncology, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Crete, Greece.
[Ti] Título:Hyperthermic isolated limb perfusion. The switch from Steinmann pins to Omni-tract assisted isolation.
[So] Source:J Surg Res;213:147-157, 2017 Jun 01.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hyperthermic isolated limb perfusion (HILP) represents an alternative to amputation for patients with either in-transit melanoma or unresectable soft tissue sarcoma, entailing delivery of high-dose chemotherapy after isolation of the extremity, under hyperthermic conditions. Stabilization of the Esmarch elastic bandage is so far performed with the use of Steinmann pins. In this study, we presented our experience with HILP and demonstrated an alternative technique for limb isolation using an Omni-tract retractor instead of the traditional Steinmann pin, while comparing the two methods. METHODS: Forty patients, 28 with recurrent in-transit melanoma and 12 with locally advanced/recurrent sarcoma of the limbs, underwent HILP in a single institution and were included in the study. The Steinmann pin was applied in the first 23 cases, whereas the Omni-tract retractor was applied in the latter 17 patients. RESULTS: The median follow-up for the whole study group was 17.5 mo, whereas the overall response rate was 92.9% for melanoma and 75% for sarcoma patients. Both overall survival and local progression-free survival differed significantly between patients with complete response and those with partial response, stable disease or progressive disease. The use of the Omni-tract retractor was advantageous in every examined field, with the overall complication rate, duration of analgesic administration, and total opioid and paracetamol dose, being significantly less in the Omni-tract patient group. CONCLUSIONS: Although this study was not a randomized trial, we consider that the noninvasive application of the Omni-tract retractor will gain significant acceptance, by contributing to the reduction of HILP complications.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Quimioterapia do Câncer por Perfusão Regional/instrumentação
Hipertermia Induzida
Melanoma/tratamento farmacológico
Sarcoma/tratamento farmacológico
Neoplasias de Tecidos Moles/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antineoplásicos/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimioterapia do Câncer por Perfusão Regional/métodos
Extremidades
Feminino
Seguimentos
Seres Humanos
Masculino
Melanoma/mortalidade
Melfalan/uso terapêutico
Meia-Idade
Estudos Prospectivos
Sarcoma/mortalidade
Neoplasias de Tecidos Moles/mortalidade
Análise de Sobrevida
Torniquetes
Resultado do Tratamento
Fator de Necrose Tumoral alfa/uso terapêutico
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Tumor Necrosis Factor-alpha); Q41OR9510P (Melphalan)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170612
[St] Status:MEDLINE



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