Multisocietal Consensus on the Use of Cytoreductive Surgery and HIPEC for the Treatment of Diffuse Malignant Peritoneal Mesothelioma: A GRADE Approach for Evidence Evaluation and Recommendation.

Autor: Kusamura S; Department of Surgical Oncology, PSM unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Cinquini M; Department of Clinical Oncology, Istituto di Richerche Farmacologiche Mario Negri IRCCS, Milan, Italy., Morris D; Department of Surgery, St. George Hospital, University of New South Wales, Sydney, Australia., Piso P; Department of General and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany., Kindler H; Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, Illinois, USA., Brandl A; Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany., Levine E; Department of Surgery, Section of Surgical Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Glehen O; Department of General Surgery and Surgical Oncology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre, Bénite, France., Kepenekian V; Department of General Surgery and Surgical Oncology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre, Bénite, France., Sgarbura O; Department of Surgical Oncology, Montpellier Cancer Institute, University of Montpellier, Montpellier, France., Sugarbaker PH; Program in Peritoneal Surface Malignancy, Washington Cancer Institute, Washington, District of Columbia, USA., Baratti D; Department of Surgical Oncology, PSM unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Marcello G; Department of Surgical Oncology, PSM unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Marcello D; Department of Surgical Oncology, PSM unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2024 Nov 28. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1002/jso.27947
Abstrakt: The Peritoneal Surface Oncology Group International (PSOGI) previously issued a recommendation endorsing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for treating diffuse malignant peritoneal mesothelioma (DMPM). However, broader acceptance of this approach, particularly within some segments of medical oncology, remains limited. To address this, PSOGI initiated a multisociety consensus effort, involving multidisciplinary International Societies, to strengthen and expand the endorsement of CRS-HIPEC for DMPM. Using the GRADE ADOLOPMENT approach, the expert panel systematically reviewed existing guidelines and evaluated the available evidence to reinforce the recommendation. The panel unanimously recommended CRS-HIPEC for a carefully selected subset of DMPM patients, emphasizing that this approach offers the best potential for improved survival compared to systemic chemotherapy alone. Despite the very low certainty of evidence, a strong recommendation was issued, reflecting the panel's recognition of the life-threatening feature of DMPM and the limited efficacy of systemic chemotherapy. This consensus also highlights the importance of centralized and expert-driven care. The recommendation aligns with previous guidelines and underscores the critical need for broader acceptance of this treatment strategy in managing this rare and aggressive malignancy.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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