2022 PSOGI Consensus on HIPEC Regimens for Peritoneal Malignancies: Diffuse Malignant Peritoneal Mesothelioma.

Autor: Kepenekian V; Service de Chirurgie Oncologique et Digestive, Hospices Civils de Lyon, Hôpital Lyon Sud, Université Lyon-1, Pierre-Bénite, Oullins, France. vahan.kepenekian@chu-lyon.fr.; Faculté de Médecine Lyon-Sud, CICLY, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France. vahan.kepenekian@chu-lyon.fr., Sgarbura O; Surgical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France., Marchal F; Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Université de Lorraine, Nancy, France., Villeneuve L; Faculté de Médecine Lyon-Sud, CICLY, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; Service de Recherche et d'Epidémiologie Cliniques, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France., Kusamura S; Peritoneal Malignancy Program, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Deraco M; Peritoneal Malignancy Program, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2023 Nov; Vol. 30 (12), pp. 7803-7813. Date of Electronic Publication: 2023 Jul 23.
DOI: 10.1245/s10434-023-13973-8
Abstrakt: Background: Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and aggressive primary peritoneal disease, with recommended treatment, in eligible patients, of a combination of complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). As treatment is multimodal, there is a wide heterogeneity of HIPEC protocols precluding clear comparisons. Standardization at an international level is required.
Methods: The Peritoneal Surface Oncology Group International (PSOGI) designated a steering committee to produce consensus recommendations for HIPEC regimens, adapted to each etiology. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology was used, based on a systematic review focused on main outcomes related to HIPEC regimens in DMPM patients and on the patient, intervention, comparator, and outcome (PICO) method to elaborate main questions. An opinion survey was added. Furthermore, a Delphi process was performed with voting from a panel of international experts.
Results: Eleven questions were elaborated, including two for future research requirements and three to assess the HIPEC regimen preference of the panel. The level of evidence underlying questions was globally low. Overall, 75 (86%) and 67 (77%) of the 87 invited experts completed the vote at the first and second round, respectively. HIPEC following complete CRS was strongly supported by 88% of voters with no need to plan comparative studies with CRS alone for 61.2% of voters. Bi-drug regimens appeared to be preferred to mono-drug ones and cisplatin was globally favored. The opinion survey confirmed the combination of cisplatin and doxorubicin as the recommended regimen.
Conclusion: International consensus confirmed the indication of HIPEC following complete CRS in DMPM patients and recommended cisplatin-doxorubicin as the first-line HIPEC regimen.
(© 2023. Society of Surgical Oncology.)
Databáze: MEDLINE
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