Archive for the 'Tumor Debulking' Category
Surgically removing as much of the tumor as possible. Also known as cytoreductive surgery in the pelvic/abdominal area.
October 13th, 2006. Morbidity and Mortality Assessment of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Diffuse Malignant Peritoneal Mesothelioma—A Prospective Study of 70 Consecutive Cases
Conclusions: The morbidity and mortality results for cytoreductive surgery and perioperative intraperitoneal chemotherapy for patients with DMPM were within the acceptable range for major gastrointestinal surgery. Grade IV morbidity was associated with more extensive cytoreduction.
Posted in Determining Efficacy, Diffuse mesothelioma, Full Archive, Intraperitoneal Chemotherapy, Peritoneal (Abdominal Mesothelioma), Surgery, Survival, Treatment, Tumor Debulking, Type of Assessment:, Type of Mesothelioma: | No Comments »
October 3rd, 2006. Toxicity and Quality of Life after Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy
Conclusions: Despite early toxicity, CS plus HIPC may prolong the overall survival rate of patients with peritoneal metastases and improve quality of life measurements.
September 25th, 2006. Clinical practice guideline on peritoneal carcinomatosis treatment using surgical cytoreduction and hyperthermic intraoperative intraperitoneal chemotherapy
Given the morbidity and mortality associated with this treatment, this procedure requires a high level of expertise. Considering the evidence available, the CEPO recommends: 1) that complete cytoreduction followed by HIPEC be used in a clinical research context only, preferably in the presence of an isolated peritoneal carcinomatosis stemming from colorectal cancer, cancer of the appendix, peritoneal pseudomyxoma, or mesothelioma of the peritoneum; 2) that studies be conducted only in specialized centers with the necessary expertise and technical resources.
September 12th, 2006. Cardiac tamponade complicating trimodal therapy for malignant mesothelioma
We report here a case of hypotension secondary to tension hydrothorax in which echocardiography and hemodynamic monitoring demonstrated evidence of tamponade physiology. Thoracentesis was lifesaving.
June 30th, 2006. Significance of lymph node metastasis in patients with diffuse malignant peritoneal mesothelioma
Conclusions: CRS and PIC showed an improved survival for DMPM, as compared to historical controls. Lymph node status along with three other prognostic variables was significant in the multivariate analysis.
June 15th, 2006. Subarachnoid-pleural fistula as a complication of malignant pleural mesothelioma
A subarachnoid-pleural fistula has to be included in the differential diagnosis of patients with recurrent pleural effusions after surgical debulkment of malignant pleural mesothelioma. The beta-trace protein may help to establish this diagnosis especially in cases where important therapeutic consequences may need to be drawn.
June 14th, 2006. An Italian Multicentric Phase II study on peritonectomy and intra peritoneal hyperthermic perfusion (IPHP) to treat patients with peritoneal mesothelioma
CRS + IPHP was proven to be acceptable in terms of morbidity and mortality in patients with PM and suggest a positive impact on outcome. Further prospective controlled studies are warranted to confirm these results.
June 14th, 2006. Cytoreduction and intraperitoneal chemotherapy for the management of non-gynecological peritoneal surface malignancy
The rationales and the outline of the current management strategies are described. Large phase II studies have demonstrated the marked survival advantage in this aggressive approach to peritoneal surface malignancy.
June 14th, 2006. Cytoreductive surgery followed by intra peritoneal hyperthermic perfusion in the treatment of peritoneal surface malignancies: morbidity and mortality with closed abdomen technique
Conclusions: CRS+ IPHP presented acceptable morbidity 3/4 toxicity and mortality rates what support the need to be tested in prospective phase III clinical trial.
Posted in Chemotherapy, Cisplatin (Platinol ®), Determining Efficacy, Doxorubicin, Full Archive, Intraperitoneal Chemotherapy, Peritoneal (Abdominal Mesothelioma), Surgery, Treatment, Tumor Debulking, Type of Assessment:, Type of Mesothelioma: | No Comments »
April 24th, 2006. Review of Patients with Peritoneal Malignancy Treated with Peritonectomy and Heated Intraperitoneal Chemotherapy
Conclusions: Morbidity is significantly associated with duration of surgery and units of blood transfused. Our findings are consistent with the international experience in patients treated with combined peritonectomy and HIPEC.
April 15th, 2006. Comprehensive management of diffuse malignant peritoneal mesothelioma
Conclusions: A new standard of care involves surgical removal of large disease deposits combined with perioperative intraperitoneal chemotherapy. Knowledgeable management uses selection criteria and incurs low morbidity and mortality.
April 12th, 2006. Perioperative intraperitoneal chemotherapy for peritoneal surface malignancy
To date, multiple different treatment regimens of perioperative intraperitoneal chemotherapy have been used. This review focuses on the perioperative intraperitoneal chemotherapy currently in use in conjunction with cytoreductive surgery for the treatment of peritoneal surface malignancy at the Washington Cancer Institute.
April 11th, 2006. Peritoneal Surface Oncology: A progress report
The following consensus points were reached: (1) cytoreductive surgery combined with perioperative intraperitoneal chemotherapy is unquestionably considered the standard of care for mucinous appendiceal tumors with peritoneal spread at the present time; (2) there is a need for standardization in the nomenclature used in this field and as a first step "HIPEC" was chosen as the recommended acronym to be used to refer to hyperthermic intraperitoneal chemotherapy in the future; (3) close international collaboration is needed to advance in the standardization of prognostic indicators, technology for HIPEC, accreditation of peritoneal surface malignancy treatment programs, anesthesia management and pathology, and ad hoc working groups were assembled for some of these issues. Future directions for clinical research in this field, especially in carcinomatosis of colorectal origin were identified and extensively discussed.
March 10th, 2006. Benign Peritoneal Cystic Mesothelioma
Conclusions: Lack of consistent definitions, various treatment approaches, and mostly short follow-up times make it difficult to draw any firm conclusions from published reports. The natural history of this rare disease is less than well clarified. When possible, in an individual patient, surgical resection with curative intent seems to be the treatment of choice.
February 1st, 2006. Prognostic Analysis of Clinicopathologic Factors in 49 Patients With Diffuse Malignant Peritoneal Mesothelioma Treated With Cytoreductive Surgery and Intraperitoneal Hyperthermic Perfusion
Conclusions: Completeness of cytoreduction, performance status, and MC seem to be the best determinants of outcome. These data warrant confirmation by a further prospective formal trial. No biological markers presented a significant correlation with the outcome. The overexpression of epidermal growth factor receptor, matrix metalloproteinase 2, and matrix metalloproteinase 9 and absent or reduced expression of p16 might be related to the underlining tumor kinetics of DMPM and warrant further investigation with other methods.
January 30th, 2006. Peritoneal Mesothelioma Treated by Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy: Results of a Prospective Study
Conclusions: A therapeutic strategy combining cytoreductive surgery with HIPEC seems to provide an adequate and efficient locoregional treatment for peritoneal mesothelioma. It is associated with acceptable morbidity when performed by an experienced surgical team. The completeness of cytoreduction is the major determinant of survival.
November 16th, 2005. Partial, but not Complete, Tumor-Debulking Surgery Promotes Protective Antitumor Memory when Combined with Chemotherapy and Adjuvant Immunotherapy
Partial debulking followed by combination therapy elicited the same proportion of cured animals but in contrast to complete resection, a memory response was invoked. We postulate that chemotherapy induced apoptosis of the residual tumor cells following incomplete resection is absolutely required for the induction of long-term immunologic memory.
November 1st, 2005. Virally directed fluorescent imaging improves diagnostic sensitivity in the detection of minimal residual disease after potentially curative cytoreductive surgery
Specificity of NV1066 infection to tumor nodules was confirmed by immunohistochemistry and by polymerase chain reaction for viral gene. Virally directed fluorescent imaging, a novel molecular imaging technology, can be used for real-time visualization of minimal residual disease after cytoreductive surgery and can improve the completeness of cure-intended resection.
October 5th, 2005. Therapeutic innovations in the management of peritoneal carcinomatosis from digestive origin: cytoreductive surgery and intraperitoneal chemotherapy
Perspectives: Combination of cytoreductive surgery with perioperative intraperitoneal chemotherapy appears to be an adapted therapeutic approach for patients strictly selected, with peritoneal carcinomatosis. Phase III studies are now needed for the validation and the evaluation of the type of intraperitoneal chemotherapy.
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