Article
Oncology
Hunter D. D. Witmer, Ankit Dhiman, Kiran K. Turaga
Summary: Surgery to remove all cancer is beneficial for patients with colorectal cancer that has spread to the peritoneum. Adding certain types of intra-abdominal chemotherapy during surgery improves survival for select patients.
Review
Medicine, General & Internal
Kevin M. Turner, Mackenzie C. Morris, Davendra Sohal, Jeffrey J. Sussman, Gregory C. Wilson, Syed A. Ahmad, Sameer H. Patel
Summary: The peritoneal cavity is a common site of metastasis from colorectal cancer, and patients often have aggressive tumor biology and poor prognosis. Cytoreductive surgery-hyperthermic intraperitoneal chemotherapy is the only effective treatment for suitable patients. The benefit of this treatment is controversial, and current strategies to prevent metastasis in high-risk individuals have been shown to be ineffective.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Oncology
Malin Ljunggren, Caroline Nordenvall, Gabriella Palmer
Summary: The study showed that patients undergoing direct surgery with CRS-HIPEC for peritoneal metastases from colorectal cancer had a good prognosis, with a median overall survival of over 3 years and disease-free survival of approximately 12.5 months. The findings question the necessity of neoadjuvant chemotherapy in all patients eligible for CRS-HIPEC.
Article
Oncology
Francois Quenet, Dominique Elias, Lise Roca, Diane Goere, Laurent Ghouti, Marc Pocard, Olivier Facy, Catherine Arvieux, Gerard Lorimier, Denis Pezet, Frederic Marchal, Valeria Loi, Pierre Meeus, Beata Juzyna, Helene de Forges, Jacques Paineau, Olivier Glehen
Summary: This study aimed to evaluate the specific benefit of adding hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery compared with receiving cytoreductive surgery alone in patients with colorectal peritoneal metastases. The results showed no significant overall survival benefit after adding HIPEC, with more frequent postoperative late complications, suggesting that cytoreductive surgery alone should be prioritized as a treatment strategy.
Review
Gastroenterology & Hepatology
Michael P. Flood, Atandrila A. Das, Mikael L. Soucisse, Joseph Kong, Robert G. Ramsay, Michael Michael, Benjamin P. T. Loveday, Satish K. Warrier, Alexander G. Heriot
Summary: The addition of synchronous liver resection to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of resectable metastatic colorectal cancer did not increase perioperative major morbidity and mortality compared to cytoreduction and hyperthermic intraperitoneal chemotherapy alone. However, the presence of liver metastases was associated with inferior disease-free and overall survival. These findings support the continued practice of liver resection, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy in select patients with stage IV colorectal cancer.
DISEASES OF THE COLON & RECTUM
(2021)
Article
Oncology
Feiling Feng, Qingxiang Gao, Yue Wu, Chen Liu, Yong Yu, Bin Li, Kaijian Chu, Bin Yi, Qingbao Cheng, Xiaoqing Jiang
Summary: The study compared advanced ICC patients undergoing CRS + HIPEC with those undergoing CRS only, finding that CRS + HIPEC resulted in longer median overall survival and lower postoperative CA19-9 levels. Although CRS + HIPEC group had a longer hospital stay, the occurrence of overall complications was similar between the two groups.
Review
Oncology
Louis Choon Kit Wong, Zhenyue Li, Qiao Fan, Joey Wee-Shan Tan, Qiu Xuan Tan, Jolene Si Min Wong, Chin-Ann Johnny Ong, Claramae Shulyn Chia
Summary: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy may improve outcomes in patients with peritoneal sarcomatosis, although there are associated complications and longer hospital stays.
Article
Oncology
Xiusen Qin, Mohamed Siyad Mohamed, Yuanxin Zhang, Yuefang Chen, Zhijie Wu, Rui Luo, Liang Yi, Hui Wang, Huaiming Wang
Summary: The present study suggests that hyperthermic intraperitoneal chemotherapy (HIPEC) following up-front resection may improve overall survival and relapse-free survival in patients with isolated synchronous colorectal peritoneal metastases.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
Hsin-Hsien Yu, Yutaka Yonemura, Hui-Ji Ng, Ming-Che Lee, Bor-Chyuan Su, Mao-Chih Hsieh
Summary: This study introduces the comprehensive treatment of using neoadjuvant laparoscopic HIPEC and bidirectional chemotherapy for gastric cancer with peritoneal carcinomatosis. The study reports the real benefit of this treatment strategy and analyzes the prognostic factors. The study also provides a recommended patient selection criteria for applying this protocol. The comprehensive treatment showed better tumor clearance and improved survival outcomes in patients with gastric cancer-associated peritoneal carcinomatosis.
Article
Surgery
Walid Ezzedine, Diane Mege, Mathilde Aubert, Julie Duclos, Remy Le Huu Nho, Igor Sielezneff, Nicolas Pirro
Summary: CRS with HIPEC is feasible in elderly patients with resectable peritoneal metastases. There were no significant differences in postoperative outcomes and survival rates between elderly and younger patients, except for a higher 90-day mortality rate in elderly patients, indicating the need for additional criteria in selecting elderly patients for this surgery.
UPDATES IN SURGERY
(2021)
Review
Gastroenterology & Hepatology
Manasi S. Parikh, Paul Johnson, Jonathan Paul Romanes, Harvey E. Freitag, Mary E. Spring, Norbert Garcia-Henriquez, John R. T. Monson
Summary: The combined treatment modality of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is considered as a potential option for colorectal peritoneal metastases. However, there is still ambiguity regarding patient selection, treatment protocols, and efficacy. This study provides an elaboration on the characteristics of patients, chemotherapy protocols, and health outcomes, with the aim of guiding future studies and establishing consensus among the medical community.
DISEASES OF THE COLON & RECTUM
(2022)
Review
Oncology
Christopher W. Mangieri, Edward A. Levine
Summary: This article provides a contemporary review of the surgical management of peritoneal surface malignancy (PSM) of colorectal origin. It includes a brief history, level I evidence, and evolving advancements, aiming to equip healthcare providers with essential knowledge and resources for treating carcinomatosis due to colorectal malignancies, although not covering all aspects.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
Hao-Chien Hung, Po-Jung Hsu, Chao-Wei Lee, Jun-Te Hsu, Ting-Jung Wu
Summary: The prognosis of gastric cancer-associated peritoneal carcinomatosis (GCPC) is poor, and current systemic chemotherapy is ineffective. This study aimed to evaluate preoperative clinical factors and identify indicative factors for predicting postoperative survival in GCPC patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
Article
Oncology
Mikael L. Soucisse, Oliver Fisher, Winston Liauw, Lana Ghanipour, Peter Cashin
Summary: This study analyzed patients with appendiceal origin PM treated with CRS + HIPEC between 2004 and 2012 at Uppsala University Hospital. The results suggest that EPIC did not provide any survival benefit in these patients and led to longer hospital and ICU stays.
Article
Gastroenterology & Hepatology
Kilian G. M. Brown, Nabila Ansari, Michael J. Solomon, Kirk K. S. Austin, Auerilius E. R. Hamilton, Christopher J. Young
Summary: The early outcomes of six patients who underwent combined pelvic exenteration, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy for advanced or recurrent colorectal cancer with peritoneal metastases suggest that this combined procedure is safe and feasible, but long-term oncological and quality of life outcomes need further investigation.
COLORECTAL DISEASE
(2021)
Article
Gastroenterology & Hepatology
Antonio Facciorusso, Rosa Paolillo, Nicola Tartaglia, Daryl Ramai, Babu P. Mohan, Christian Cotsoglou, Saurabh Chandan, Antonio Ambrosi, Irene Bargellini, Matteo Renzulli, Rodolfo Sacco
Summary: This study evaluated the efficacy and safety of radioembolization plus sorafenib in hepatocellular carcinoma patients. The results showed no significant difference between the combined therapy and radioembolization alone in terms of overall survival and progression-free survival. There was also no significant difference in the occurrence of severe adverse events between the two treatment regimens.
DIGESTIVE AND LIVER DISEASE
(2022)
Review
Oncology
Simone Frassini, Francesca Calabretto, Stefano Granieri, Paola Fugazzola, Jacopo Vigano, Nicola Fazzini, Luca Ansaloni, Lorenzo Cobianchi
Summary: This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of intraperitoneal treatments in managing pancreatic cancer. The results suggest that HIPEC may be a promising technique for preventing and treating peritoneal metastasis in borderline resectable and locally advanced disease. Additionally, PIPAC and NIPEC as palliative treatments appear to have more favorable survival rates compared to existing literature.
Review
Emergency Medicine
Stefano Granieri, Simone Frassini, Stefania Cimbanassi, Alessandro Bonomi, Sissi Paleino, Laura Lomaglio, Andrea Chierici, Federica Bruno, Raoul Biondi, Salomone Di Saverio, Mansoor Khan, Christian Cotsoglou
Summary: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) shows survival benefits and post-procedural hemodynamic improvement in treating multiple sites subdiaphragmatic hemorrhage, but may lead to post-procedural complications.
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
(2022)
Article
Surgery
Stefano Piero Bernardo Cioffi, Stefano Granieri, Luca Scaravilli, Mattia Molteni, Michele Altomare, Andrea Spota, Francesco Virdis, Roberto Bini, Federica Renzi, Elisa Reitano, Roberta Ragozzino, Shailvi Gupta, Osvaldo Chiara, Stefania Cimbanassi
Summary: This study investigates the influence of surgeon's subjectivity on the decision-making process of peritoneal lavage during laparoscopic appendectomy. The study found that surgeons tend to overestimate the severity of acute appendicitis and this perception affects the choice of performing peritoneal lavage.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Oncology
Stefano Granieri, Christian Cotsoglou, Alessandro Bonomi, Lisa Salvatore, Roberto Filippi, Olga Nigro, Fabio Gelsomino, Ina Valeria Zurlo, Ilaria Depetris, Riccardo Giampieri, Rossana Berardi, Cristina Morelli, Michele De Tursi, Michela Roberto, Elson Gjoni, Alessandro Germini, Nicola de Angelis, Riccardo Memeo, Antonio Facciorusso, Ornella Garrone, Daryl Ramai, Michele Ghidini, Alessandro Parisi
Summary: In patients with left-sided RAS/BRAF wild-type colorectal cancer and liver-limited metastatic disease, a conversion strategy can improve survival outcomes. There is no difference in survival between ultimately resectable patients and those who had liver resection with perioperative systemic treatment.
Review
Gastroenterology & Hepatology
Andrea Chierici, Stefano Granieri, Alice Frontali
Summary: This study evaluated the diagnostic accuracy of water-soluble contrast enema (WSCE), contrast enema computed tomography (CECT), and endoscopy in identifying anastomotic leakage (AL), and identified the most accurate diagnostic procedure. The results showed that CECT had significantly higher sensitivity than WSCE, while endoscopy had similar sensitivity and specificity to CECT. In general, WSCE had lower diagnostic accuracy compared to endoscopy and CECT.
COLORECTAL DISEASE
(2023)
Review
Gastroenterology & Hepatology
Stefano Granieri, Alessandro Bonomi, Simone Frassini, Elson Gjoni, Alessandro Germini, Alessia Kersik, Greta Bracchetti, Federica Bruno, Sissi Paleino, Laura Lomaglio, Alice Frontali, Christian Cotsoglou
Summary: According to a systematic review, Kimura surgery is superior to Warshaw surgery in reducing the risk of splenic infarction and gastric varices. For benign pancreatic tumors and low-grade malignancies, Kimura surgery may be preferred.
Review
Oncology
Stefano Granieri, Alessia Kersik, Alessandro Bonomi, Simone Frassini, Davide Bernasconi, Sissi Paleino, Alessandro Germini, Elson Gjoni, Christian Cotsoglou
Summary: Lymph node metastases have a negative impact on the survival outcomes of patients with pancreatic cancer of the body and tail. This study systematically reviewed the literature to explore the incidence and prognostic impact of non-peripancreatic lymph nodes (PLNs) in these patients. The results showed an increased risk of death for patients with positive non-PLNs. Based on these findings, a systematic extended lymphadenectomy is not currently recommended for these patients.
Article
Surgery
Roberto Bellini, Maria Chiara Salandini, Stefano Granieri, Andrea Chierici, Rita Passaretta, Christian Cotsoglou
Summary: This study analyzed the safety and efficacy of non-intubated video-assisted thoracoscopy (NI-VATS) with erector-spinae plane block (ESPB) as anesthesia for the diagnosis and palliation of malignant pleural effusion in elderly patients. A total of 158 patients who underwent surgery for malignant pleural effusion were included in the analysis. After propensity score matching, it was found that NI-VATS patients were older and had more severe pre-existing comorbidities compared to those who underwent surgery under general anesthesia (GA). However, there were no differences in postoperative opioid consumption, complication rate, and postoperative hospitalization between the two groups. The overall length of stay in the operative room and operative time were significantly shorter in the NI-VATS group. ESPB NI-VATS is a safe and effective option for the diagnosis and palliation of malignant pleural effusion in elderly and frail patients.
UPDATES IN SURGERY
(2023)
Article
Surgery
Simone Frassini, Francesca Calabretto, Stefano Granieri, Paola Fugazzola, Matteo Massaro, Benedetta Sargenti, Luca Schiavone, Simone Zanghi, Francesca Dal Mas, Luca Ansaloni, Lorenzo Cobianchi
Summary: Prophylactic mesh augmentation in midline laparotomy closure can be considered safe and effective in reducing the incidence of incisional hernia.
Article
Oncology
Yuchao Liu, Zijia Liu, Liangyan Zhang, Yuelun Zhang, Ningchen Zhang, Yue Han, Le Shen
Summary: This study found an association between preoperative 6-min walk distance and postoperative complications in patients undergoing laparoscopic gastrointestinal cancer surgery.
Review
Oncology
Matteo Pavone, Rosa Autorino, Nicolo Bizzarri, Giuditta Chilorio, Vincenzo Valentini, Giacomo Corrado, Gabriella Ferrandina, Gabriella Macchia, Maria Antonietta Gambacorta, Giovanni Scambia, Denis Querleu
Summary: Ovarian transposition is an established method for protecting the ovaries from radiation, while surgical procedures for protecting the uterus are still under investigation. This study conducted a systematic review of uterine displacement techniques and performed dose simulation to assess the radiation dose received by the uterus. The results showed that the transposition approach was the most protective.
Article
Oncology
Silvia Ministrini, Maria Bencivenga, Federica Filippini, Gianni Mura, Carlo Milandri, Maria Antonietta Mazzei, Giulio Bagnacci, Mattia Berselli, Manlio Monti, Paolo Morgagni, Leonardo Solaini, Daniele Marrelli, Stefania Piccioni, Stefano De Pascale, Luigina Graziosi, Rossella Reddavid, Fausto Rosa, Claudio Belluco, Guido Tiberio
Summary: The Italian Research Group for Gastric Cancer developed a prospective database to evaluate the impact of a pragmatic attitude on the management of stage IV gastric cancer patients. The study found that different metastatic sites did not affect survival rates, but multiple metastatic sites were associated with worse survival. Patients who could undergo curative resection had better survival rates. A more accurate diagnostic workup and staging had a favorable impact on survival.
Article
Oncology
Luca Lambertini, Fabrizio Di Maida, Anna Cadenar, Samuele Nardoni, Antonio Andrea Grosso, Francesca Valastro, Pietro Spinelli, Riccardo Fantechi, Agostino Tuccio, Gianni Vittori, Andrea Mari, Lorenzo Masieri, Andrea Minervini
Summary: The aim of this study was to evaluate the functional outcomes of Florence intracorporeal neobladder (FloRIN) configuration technique performed with a stentless procedure. The results showed that the stentless procedure was associated with shorter console time and lower estimated blood loss compared to the stent group. There were no significant differences in terms of perioperative features and mid-term functional outcomes between the two groups.
Article
Oncology
Geun-Jeon Kim, Jooin Bang, Hyun-Il Shin, Sang-Yeon Kim, Dong -Il Sun
Summary: This study evaluated the outcome of tonsillar cancer managed with neoadjuvant chemotherapy followed by surgery. The results showed that neoadjuvant chemotherapy reduced tumor volume and pathological adverse features, significantly decreasing the need for adjuvant therapy. A greater reduction in tumor volume predicted a complete pathologic response. There was no significant difference in survival rates between the groups.
Article
Oncology
Alexandra Nassar, Stylianos Tzedakis, Ugo Marchese, Gaanan Naveendran, Remy Sindayigaya, Martin Gaillard, Francois Cauchy, Mickael Lesurtel, Brice Gayet, Olivier Soubrane, David Fuks
Summary: This study identified recurrence between the two stages and a larger tumor size in the future liver remnant as critical factors contributing to the failure of two-stage hepatectomy for bilobar colorectal liver metastases. These findings have important clinical implications for the selection and evaluation of TSH surgery.
Letter
Oncology
Michele Fiore, Gian Marco Petrianni, Gabriele D'Ercole, Pasquale Trecca, Sara Ramella
Review
Oncology
Harry Farrow, Oliver J. Pickering, James A. Gossage, Philip H. Pucher
Summary: The inclusion or exclusion of the thoracic duct in radical esophagectomy for esophageal cancer is a controversial issue. While removing the thoracic duct may increase lymph node yield, it may also lead to higher morbidity without any survival benefit.
Article
Oncology
Xiaokun Li, Siyuan Luan, Chi Zhang, Weili Kong, Xin Xiao, Haowen Zhang, Jianfeng Zhou, Yushang Yang, Yang Xu, Yong Qiang, Pinhao Fang, Yi Shen, Yong Yuan
Summary: This study proposes a new staging system based on ypTNM stage and cN status for early stage ESCC patients after nCRT. The new ypTNM-cN staging system demonstrates superior predictive ability and classification efficacy compared to the AJCC 8th ypTNM staging system. It provides new insights for accurately stratifying ypI stage ESCC patients.
