Current Opinion on Peritoneal Carcinomatosis Treatment: a Survey of the Indian Society of Peritoneal Surface Malignancie
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ORIGINAL RESEARCH
Current Opinion on Peritoneal Carcinomatosis Treatment: a Survey of the Indian Society of Peritoneal Surface Malignancies (ISPSM) David Martin 1 & F. Grass 1 & S. V. S. Deo 2 & K. R. Ashwin 3 & A. Maheshwari 4 & M. Hübner 1 & S. P. Somashekhar 3 Accepted: 12 October 2020 # The Author(s) 2020
Abstract Purpose Patients with peritoneal carcinomatosis (PC) are increasingly treated with multidisciplinary combined approaches. The study aim was to assess current practice and perceptions of treatment modalities of PC. Methods Indian Society of Peritoneal Surface Malignancies (ISPSM) members were invited to complete an online survey. Current practice and perceptions of treatment modalities were assessed through 19 closed questions. Scores were assessed using a Likert scale (0: not important, 5: very important). Treatment modality satisfaction was assessed using a semantic scale (frustrated: 0, perfectly happy: 10). Participants were sent 3 reminders at 4-week intervals. Results Fifty-seven out of 182 members completed the survey (31%). Forty percent of participants had an experience of at least 10 years, and 75% stated treating less than 20 PC patients per year. Main treatment goals for patients with PC were cure (5/5) and symptom relief (4/5). Participant’s satisfaction with treatment modalities for ovarian, colorectal, and gastric PC were 6/10, 5/10, and 2/10, respectively. Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian (57%) and colorectal (44%) origins were considered to be useful. Clinical usefulness of chemotherapy for gastric PC was rated to be low (17%). Conclusions Current treatment modalities fall short to satisfy the needs (cure, symptom relief) of patients with PC. Alternative systemic and intraperitoneal treatment modalities should be assessed. Keywords Peritoneal carcinomatosis . Treatment . Survey
Introduction The prognosis for peritoneal carcinosis (PC) is poor and the re sp ons e t o s yste mic ch em o t h e r a p y l i m i t e d [ 1 ]. Intraperitoneal treatment has brought some progress, especially for ovarian cancer [2]. Several studies reporting on systemic Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12029-020-00538-1) contains supplementary material, which is available to authorized users. * David Martin [email protected] 1
Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland
2
Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
3
Department of Surgical Oncology, Manipal Hospital, Bangalore, India
4
Department of Gynecological Oncology, Tata Memorial Cancer Hospital, Mumbai, India
chemotherapy and symptom-directed surgery without cytoreduction demonstrated a median survival ranging from 3 to 7 months for patients with PC from non-gynecologic malignancies [3, 4]. The combination of systemic chemotherapy after extensive cytoreductive surgery (CRS) with concurrent heated intraperitoneal chemotherapy (HIPEC) has demonstrated a remarkable
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