title: hyperthermic intraperitoneal chemotherapy for ... · prolongs survival but is not curative...
TRANSCRIPT
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TITLE: Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis: Clinical Effectiveness and Guidelines
DATE: 01 November 2016
RESEARCH QUESTIONS
1. What is the clinical effectiveness of hyperthermic intraperitoneal chemotherapy for the
treatment of peritoneal carcinomatosis?
2. What are the evidence-based guidelines regarding hyperthermic intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis?
KEY FINDINGS
Two systematic reviews, two randomized controlled trials, four non-randomized studies, and one evidence-based guideline were identified regarding hyperthermic intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis. METHODS
A limited literature search was conducted on key resources including PubMed, The Cochrane Library, University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search. Methodological filters were applied to limit retrieval to health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies, and guidelines. Where possible, retrieval was limited to the human population. The search was also limited to English language documents published between January 1, 2011 and October 17, 2016. Internet links were provided, where available. The summary of findings was prepared from the abstracts of the relevant information. Please note that data contained in abstracts may not always be an accurate reflection of the data contained within the full article.
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 2
SELECTION CRITERIA
One reviewer screened citations and selected studies based on the inclusion criteria presented in Table 1.
Table 1: Selection Criteria
Population Adult patients with peritoneal carcinomatosis/carcinosis
Intervention Hyperthermic intraperitoneal chemotherapy (HIPEC) Comparator Alternate cancer treatments (e.g., systemic chemotherapy),
placebo,
no treatment
Outcomes Clinical benefits and harms (e.g., survival, morbidity and mortality), guidelines
Study Designs Health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies, evidence-based
guidelines
RESULTS
Rapid Response reports are organized so that the higher quality evidence is presented first. Therefore, health technology assessment reports, systematic reviews, and meta-analyses are presented first. These are followed by randomized controlled trials, non-randomized studies, and evidence-based guidelines. Two systematic reviews, two randomized controlled trials, four non-randomized studies, and one evidence-based guideline were identified regarding hyperthermic intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis. No relevant health technology assessments were identified. Additional references of potential interest are provided in the appendix. OVERALL SUMMARY OF FINDINGS
Two relevant systematic reviews1,2 (SRs) were identified. One review1 examined the literature regarding hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of gastric peritoneal metastasis. The authors identified a small number of relevant trials and concluded that HIPEC may be effective when a complete, or almost complete, resection of the peritoneal metastases can be successfully done. The second SR2 focused on patients with colorectal cancer with liver and peritoneal metastases who underwent resection and HIPEC. The authors identified a trend towards an increase in median survival for patients who underwent resection of both types of metastases with HIPEC as compared to similar patients who underwent modern systemic chemotherapy. Two randomized controlled trials3,4 and four non-randomized studies5-8 were identified. The characteristics and results of these studies are summarized in Table 2. One guideline9 from the American Society of Colon and Rectal Surgeons was identified that recommends “the treatment of patients with peritoneal carcinomatosis should be
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 3
multidisciplinary and individualized and may include surgical cytoreduction. The role of intraperitoneal chemotherapy remains insufficiently defined.” (page 838)
Table 2: Summary of Clinical Study Results
First Author, Year
Patient Characteristics
Intervention and Comparator
Results and Authors’ Conclusions
Randomized Controlled Trials
Rudloff, 20143 Patients with measurable metastatic gastric adenocarcinoma involving the peritoneum N = 17
Gastrectomy, metastasectomy, HIPEC and systemic FOLFOXIRI versus FOLFOXIRI alone
Median OS was 11.3 months for the combined intervention and 4.3 months in the chemotherapy group
Two patients in the combined group survived beyond 12 months
Yang, 20114 Peritoneal carcinomatosis of gastric cancer N = 68
CRS + HIPEC versus CRS alone
Median survival o HIPEC group =
11.0 months o surgical group =
6.5 months
Median follow-up of 32 months o 85.3% of patients
in the HIPEC group had died
o 97.1% of patients in the surgical group had died
The authors suggested surgery + HIPEC may improve survival with acceptable morbidity
Non-Randomized Studies Boemer, 20165
Peritoneal carcinomatosis of gastric cancer N = 38
Gastrectomy + CRS + HIPEC versus Palliative management (with or without gastrectomy)
Median survival time o CRS + HIPEC =
17.2 months o Palliative = 11.0
months Two year survival
o CRS + HIPEC = 35.8%
o Palliative = 16.9%
Huang, 20146 Colorectal cancer peritoneal carcinomatosis
CRS + HIPEC versus
Complete cytoreduction o CRS + HIPEC =
42.4%
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 4
Table 2: Summary of Clinical Study Results
First Author, Year
Patient Characteristics
Intervention and Comparator
Results and Authors’ Conclusions
N = 62 CRS alone o CRS alone = 31.0%
Median OS o CRS + HIPEC =
13.7% o CRS alone = 8.5%
SAEs 30-days post-operative o CRS + HIPEC =
28.6% o CRS alone = 9.4%
The authors concluded that CRS + HIPEC could improve OS for these patients
Marcotte, 20147
Appendiceal peritoneal carcinomatosis N = 78
CRS + HIPEC (oxaliplatin) versus No CRS or HIPEC; Negative second-look with no HIPEC
5 year OS for the whole cohort = 66.2% o HIPEC = 77% o No HIPEC = 9% o Second-look =
100%
Cashin, 20128 Peritoneal carcinomatosis from colon cancer N = 32
HIPEC versus SPIC
Median OS o HIPEC = 36.5
months o SPIC = 23.9
months
Median disease-free survival o HIPEC = 22.8
months o SPIC = 13.0
months
Morbidity was not significantly different between groups
CRS = cytoreductive surgery; EPIC = early postoperative intraperitoneal chemotherapy; FOLFOXIRI = folinic acid, f luorouracil, oxaliplatin, irinotecan; HIPEC = hyperthermic intraperitoneal chemotherapy; OS = overall survival; SPIC = normothermic sequential postoperative intraperitoneal chemotherapy.
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 5
REFERENCES SUMMARIZED
Health Technology Assessments
No literature identified. Systematic Reviews and Meta-analyses
1. Di Vita M, Cappellani A, Piccolo G, Zanghi A, Cavallaro A, Bertola G, et al. The role of
HIPEC in the treatment of peritoneal carcinomatosis from gastric cancer: between lights and shadows. Anticancer Drugs. 2015 Feb;26(2):123-38. PubMed: PM25406023
2. de Cuba EM, Kwakman R, Knol DL, Bonjer HJ, Meijer GA, Te Velde EA. Cytoreductive surgery and HIPEC for peritoneal metastases combined with curative treatment of colorectal liver metastases: systematic review of all literature and meta-analysis of observational studies. Cancer Treat Rev. 2013 Jun;39(4):321-7. PubMed: PM23244778
Randomized Controlled Trials
3. Rudloff U, Langan RC, Mullinax JE, Beane JD, Steinberg SM, Beresnev T, et al. Impact of
maximal cytoreductive surgery plus regional heated intraperitoneal chemotherapy (HIPEC) on outcome of patients with peritoneal carcinomatosis of gastric origin: results of the GYMSSA trial. J Surg Oncol. 2014 Sep;110(3):275-84. PubMed: PM25042700
4. Yang XJ, Huang CQ, Suo T, Mei LJ, Yang GL, Cheng FL, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial. Ann Surg Oncol [Internet]. 2011 Jun [cited 2016 Oct 27];18(6):1575-81. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087875 PubMed: PM21431408
Non-Randomized Studies
5. Boerner T, Graichen A, Jeiter T, Zemann F, Renner P, Marz L, et al. CRS-HIPEC
Prolongs survival but is not curative for patients with peritoneal carcinomatosis of gastric cancer. Ann Surg Oncol. 2016 Nov;23(12):3972-7. PubMed: PM27313067
6. Huang CQ, Feng JP, Yang XJ, Li Y. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from colorectal cancer: a case-control study from a Chinese center. J Surg Oncol [Internet]. 2014 Jun [cited 2016 Oct 27];109(7):730-9. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283734 PubMed: PM24374987
http://www.ncbi.nlm.nih.gov/pubmed/25406023http://www.ncbi.nlm.nih.gov/pubmed/23244778http://www.ncbi.nlm.nih.gov/pubmed/25042700http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087875http://www.ncbi.nlm.nih.gov/pubmed/21431408http://www.ncbi.nlm.nih.gov/pubmed/27313067http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283734http://www.ncbi.nlm.nih.gov/pubmed/24374987
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 6
7. Marcotte E, Dube P, Drolet P, Mitchell A, Frenette S, Leblanc G, et al. Hyperthermic intraperitoneal chemotherapy with oxaliplatin as treatment for peritoneal carcinomatosis arising from the appendix and pseudomyxoma peritonei: a survival analysis. World J Surg Oncol [Internet]. 2014 Nov 7 [cited 2016 Oct 27];12:332. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233099 PubMed: PM25380618
8. Cashin PH, Graf W, Nygren P, Mahteme H. Intraoperative hyperthermic versus postoperative normothermic intraperitoneal chemotherapy for colonic peritoneal carcinomatosis: a case-control study. Ann Oncol. 2012 Mar;23(3):647-52. PubMed: PM21685413
Guidelines and Recommendations
9. Chang GJ, Kaiser AM, Mills S, Rafferty JF, Buie WD. Practice parameters for the
management of colon cancer. Dis Colon Rectum [Internet]. 2012 Aug [cited 2016 Oct 27];55(8):831-43. Available from: https://www.fascrs.org/sites/default/files/downloads/publication/practice_parameters_for_the_management_of_colon.21.pdf
See: Management of Peritoneal Carcinomatosis, page 838 PREPARED BY:
Canadian Agency for Drugs and Technologies in Health Tel: 1-866-898-8439 www.cadth.ca
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233099http://www.ncbi.nlm.nih.gov/pubmed/25380618http://www.ncbi.nlm.nih.gov/pubmed/21685413https://www.fascrs.org/sites/default/files/downloads/publication/practice_parameters_for_the_management_of_colon.21.pdfhttps://www.fascrs.org/sites/default/files/downloads/publication/practice_parameters_for_the_management_of_colon.21.pdfhttp://www.cadth.ca/
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 7
APPENDIX – FURTHER INFORMATION: Systematic Reviews – Only Executive Summary Available in English
10. Ubago‐Pérez R, Matas‐Hoces A, Beltrán‐Calvo C, Romero‐Tabares A. Hyperthermic intraperitoneal chemotherapy. Efficacy and safety in the treatment of ovarian cancer peritoneal carcino mitosis [Internet]. Seville: Andalusian Agency for Health Technology Assessment (AETSA); 2013 [cited 2016 Oct 27]. Available from: http://www.juntadeandalucia.es/salud/servicios/contenidos/nuevaaetsa/up/AETSA_2012_6_HIPEC_eng.pdf
Clinical Practice Guidelines – Methodology Not Specified
11. Van Cutsem E, Cervantes A, Nordlinger B, Arnold D; ESMO Guidelines Working Group Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol [Internet]. 2014 Sep [cited 2016 Oct 27];25 Suppl 3:iii1-9. Available from: http://annonc.oxfordjournals.org/content/25/suppl_3/iii1.full.pdf See: page iii6
Consensus Statements
12. Turaga K, Levine E, Barone R, Sticca R, Petrelli N, Lambert L, et al. Consensus
guidelines from The American Society of Peritoneal Surface Malignancies on standardizing the delivery of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer patients in the United States. Ann Surg Oncol. 2014 May;21(5):1501-5. PubMed: PM23793364
Non-Randomized Studies
No Comparator Group
13. Hinkle NM, MacDonald J, Sharpe JP, Dickson P, Deneve J, Munene G. Cytoreduction
with hyperthermic intraperitoneal chemotherapy: an appraisal of outcomes and cost at a newly established peritoneal malignancy program. Am J Surg. 2016 Sep;212(3):413-8. PubMed: PM27086201
14. Honore C, Goere D, Macovei R, Colace L, Benhaim L, Elias D. Peritoneal carcinomatosis from unusual cancer origins: is there a role for hyperthermic intraperitoneal chemotherapy? J Visc Surg. 2016 Apr;153(2):101-7. PubMed: PM26698380
15. Liu L, Zhang N, Min J, Su H, Wang H, Chen D, et al. Retrospective analysis on the safety of 5,759 times of bedside hyperthermic intra-peritoneal or intra-pleural chemotherapy (HIPEC). Oncotarget [Internet]. 2016 Apr 19 [cited 2016 Oct 27];7(16):21570-8. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008306 PubMed: PM26919243
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 8
16. Manzanedo I, Pereira F, Perez-Viejo E, Serrano A, Hernandez-Garcia M, Martinez-Torres B, et al. Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) with primary or secondary cytoreductive surgery in the treatment of advanced epithelial ovarian cancer. Minerva Ginecol. 2016 Jul 14. [Epub ahead of print] PubMed: PM27415829
17. Munoz-Casares FC, Medina-Fernandez FJ, Arjona-Sanchez A, Casado-Adam A, Sanchez-Hidalgo JM, Rubio MJ, et al. Peritonectomy procedures and HIPEC in the treatment of peritoneal carcinomatosis from ovarian cancer: long-term outcomes and perspectives from a high-volume center. Eur J Surg Oncol. 2016 Feb;42(2):224-33. PubMed: PM26673283
18. Passot G, Vaudoyer D, Villeneuve L, Kepenekian V, Beaujard AC, Bakrin N, et al. What
made hyperthermic intraperitoneal chemotherapy an effective curative treatment for peritoneal surface malignancy: a 25-year experience with 1,125 procedures. J Surg Oncol. 2016 Jun;113(7):796-803. PubMed: PM27110915
19. Cardi M, Sammartino P, Mingarelli V, Sibio S, Accarpio F, Biacchi D, et al. Cytoreduction and HIPEC in the treatment of "unconventional" secondary peritoneal carcinomatosis. World J Surg Oncol [Internet]. 2015 Oct 22 [cited 2016 Oct 27];13:305. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618525 PubMed: PM26493405
20. Coccolini F, Campanati L, Catena F, Ceni V, Ceresoli M, Jimenez CJ, et al. Hyperthermic intraperitoneal chemotherapy with cisplatin and paclitaxel in advanced ovarian cancer: a multicenter prospective observational study. J Gynecol Oncol [Internet]. 2015 Jan [cited 2016 Oct 27];26(1):54-61. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302286 PubMed: PM25376916
21. Braam HJ, van Oudheusden TR, de Hingh I, Nienhuijs SW, Boerma D, Wiezer MJ, et al. Patterns of recurrence following complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. J Surg Oncol. 2014 Jun;109(8):841-7. PubMed: PM24619813
22. Delotte J, Desantis M, Frigenza M, Quaranta D, Bongain A, Benchimol D, et al. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of endometrial cancer with peritoneal carcinomatosis. Eur J Obstet Gynecol Reprod Biol. 2014 Jan;172:111-4. PubMed: PM24300558
23. Jafari MD, Halabi WJ, Stamos MJ, Nguyen VQ, Carmichael JC, Mills SD, et al. Surgical outcomes of hyperthermic intraperitoneal chemotherapy: analysis of the American College of Surgeons National Surgical Quality Improvement Program. JAMA Surg. 2014 Feb;149(2):170-5. PubMed: PM24352601
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 9
24. Jimenez WA, Sardi A, Nieroda C, Gushchin V. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of recurrent high-grade uterine sarcoma with peritoneal dissemination. Am J Obstet Gynecol. 2014 Mar;210(3):259-8. PubMed: PM24211479
25. Kuijpers AM, Mehta AM, Boot H, van Leerdam ME, Hauptmann M, Aalbers AG, et al. Perioperative systemic chemotherapy in peritoneal carcinomatosis of lymph node positive colorectal cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Ann Oncol. 2014 Apr;25(4):864-9. PubMed: PM24667719
26. Robella M, Vaira M, Marsanic P, Mellano A, Borsano A, Cinquegrana A, et al. Treatment of peritoneal carcinomatosis from ovarian cancer by surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). Minerva Chir. 2014 Feb;69(1):27-35. PubMed: PM24675244
27. van Oudheusden TR, Braam HJ, Nienhuijs SW, Wiezer MJ, van Ramshorst B, Luyer MD, et al. Cytoreduction and hyperthermic intraperitoneal chemotherapy: a feasible and effective option for colorectal cancer patients after emergency surgery in the presence of peritoneal carcinomatosis. Ann Surg Oncol. 2014 Aug;21(8):2621-6. PubMed: PM24671638
28. Bakrin N, Bereder JM, Decullier E, Classe JM, Msika S, Lorimier G, et al. Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 566 patients. Eur J Surg Oncol. 2013 Dec;39(12):1435-43. PubMed: PM24209430
29. Bakrin N, Gilly FN, Baratti D, Bereder JM, Quenet F, Lorimier G, et al. Primary peritoneal serous carcinoma treated by cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. A multi-institutional study of 36 patients. Eur J Surg Oncol. 2013 Jul;39(7):742-7. PubMed: PM23510853
30. Canda AE, Sokmen S, Terzi C, Arslan C, Oztop I, Karabulut B, et al. Complications and toxicities after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol. 2013 Apr;20(4):1082-7. PubMed: PM23456387
Alternate Comparators 31. Alyami M, Lundberg P, Kepenekian V, Goere D, Bereder JM, Msika S, et al. Cytoreductive
surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis in the elderly: a case-controlled, multicenter study. Ann Surg Oncol. 2016 Sep 6. [Epub ahead of print] PubMed: PM27600619
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 10
32. Simkens GA, van Oudheusden TR, Braam HJ, Luyer MD, Wiezer MJ, van Ramshorst B, et al. Treatment-related mortality after cytoreductive surgery and HIPEC in patients with colorectal peritoneal carcinomatosis is underestimated by conventional parameters. Ann Surg Oncol. 2016 Jan;23(1):99-105. PubMed: PM26148758
33. Sun JH, Ji ZH, Yu Y, Wu HT, Huang CQ, Zhang Q, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat advanced/recurrent epithelial ovarian cancer: results from a retrospective study on prospectively established database. Transl Oncol [Internet]. 2016 Apr [cited 2016 Oct 27];9(2):130-8. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833965 PubMed: PM27084429
34. Bommareddi SR, Simianu VV, Mann LV, Mann GN. High-quality results of cytoreductive surgery and heated intraperitoneal chemotherapy perfusion for carcinomatosis at a low volume institution. J Surg Oncol [Internet]. 2015 Aug [cited 2016 Oct 27];112(2):219-24. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655820 PubMed: PM26274508
35. Kuijpers AM, Aalbers AG, Nienhuijs SW, de Hingh I, Wiezer MJ, van Ramshorst B, et al. Implementation of a standardized HIPEC protocol improves outcome for peritoneal malignancy. World J Surg. 2015 Feb;39(2):453-60. PubMed: PM25245434
36. Prada-Villaverde A, Esquivel J, Lowy AM, Markman M, Chua T, Pelz J, et al. The American Society of Peritoneal Surface Malignancies evaluation of HIPEC with mitomycin C versus oxaliplatin in 539 patients with colon cancer undergoing a complete cytoreductive surgery. J Surg Oncol. 2014 Dec;110(7):779-85. PubMed: PM25088304
37. Spiliotis JD, Halkia E, Boumis VA, Vassiliadou DT, Pagoulatou A, Efstathiou E. Cytoreductive surgery and HIPEC for peritoneal carcinomatosis in the elderly. Int J Surg Oncol [Internet]. 2014 [cited 2016 Oct 27];2014:987475. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009200 PubMed: PM24809147
Alternate Interventions 38. Huang Y, Alzahrani NA, Liauw W, Traiki TB, Morris DL. Early postoperative intraperitoneal
chemotherapy for low-grade appendiceal mucinous neoplasms with pseudomyxoma peritonei: is it beneficial? Ann Surg Oncol. 2016 Oct 7. [Epub ahead of print] PubMed: PM27718032
39. Maillet M, Glehen O, Lambert J, Goere D, Pocard M, Msika S, et al. Early postoperative chemotherapy after complete cytoreduction and hyperthermic intraperitoneal chemotherapy for isolated peritoneal carcinomatosis of colon cancer: a multicenter study. Ann Surg Oncol. 2016 Mar;23(3):863-9. PubMed: PM26480848
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Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis 11
40. Lam JY, McConnell YJ, Rivard JD, Temple WJ, Mack LA. Hyperthermic intraperitoneal chemotherapy + early postoperative intraperitoneal chemotherapy versus hyperthermic intraperitoneal chemotherapy alone: assessment of survival outcomes for colorectal and high-grade appendiceal peritoneal carcinomatosis. Am J Surg. 2015 Sep;210(3):424-30. PubMed: PM26051744
41. Sparks DS, Morris B, Xu W, Fulton J, Atkinson V, Meade B, et al. Cytoreductive surgery and heated intraperitoneal chemotherapy for peritoneal carcinomatosis secondary to mucinous adenocarcinoma of the appendix. Int Surg [Internet]. 2015 Jan [cited 2016 Oct 27];100(1):21-8. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301290 PubMed: PM25594636
42. Glockzin G, von Breitenbuch P, Schlitt HJ, Piso P. Treatment-related morbidity and toxicity of CRS and oxaliplatin-based HIPEC compared to a mitomycin and doxorubicin-based HIPEC protocol in patients with peritoneal carcinomatosis: a matched-pair analysis. J Surg Oncol. 2013 May;107(6):574-8. PubMed: PM22833286
Quality of Life 43. Chia CS, Tan GH, Lim C, Soo KC, Teo MC. Prospective quality of life study for colorectal
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44. Ford J, Hanna M, Boston A, Berri R. Life after hyperthermic intraperitoneal chemotherapy; measuring quality of life and performance status after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Am J Surg. 2016 Mar;211(3):546-50. PubMed: PM26778767
Review Articles
45. Feingold PL, Kwong ML, Sabesan A, Sorber R, Rudloff U. Cytoreductive surgery and
hyperthermic intraperitoneal chemotherapy for gastric cancer and other less common disease histologies: is it time? J Gastrointest Oncol [Internet]. 2016 Feb [cited 2016 Oct 27];7(1):87-98. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754313 PubMed: PM26941987
46. Li Y, Zhou YF, Liang H, Wang HQ, Hao JH, Zhu ZG, et al. Chinese expert consensus on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal malignancies. World J Gastroenterol [Internet]. 2016 Aug 14 [cited 2016 Oct 27];22(30):6906-16. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974588 PubMed: PM27570426
47. Polom K, Roviello G, Generali D, Marano L, Petrioli R, Marsili S, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for treatment of ovarian cancer. Int J Hyperthermia. 2016 May;32(3):298-310. PubMed: PM26984715
http://www.ncbi.nlm.nih.gov/pubmed/26051744http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301290http://www.ncbi.nlm.nih.gov/pubmed/25594636http://www.ncbi.nlm.nih.gov/pubmed/22833286http://www.ncbi.nlm.nih.gov/pubmed/27016293http://www.ncbi.nlm.nih.gov/pubmed/26778767http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754313http://www.ncbi.nlm.nih.gov/pubmed/26941987http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974588http://www.ncbi.nlm.nih.gov/pubmed/27570426http://www.ncbi.nlm.nih.gov/pubmed/26984715
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48. Rajeev R, Turaga KK. Hyperthermic intraperitoneal chemotherapy and cytoreductive surgery in the management of peritoneal carcinomatosis. Cancer Control. 2016 Jan;23(1):36-46. PubMed: PM27009455
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Research QuestionsKey FindingsMethodsResultsOverall Summary of FindingsReferences SummarizedAppendix – Further information: