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Israel Manzanedo

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Manzanedo I, Pereira F, Cascales-Campos P, Muñoz-Casares C, Asensio E, Torres-Melero J, Prada-Villaverde A, Caravaca-García I, Gutiérrez-Calvo A, Vaqué J, Ortega G, Titos-García A, González-Sánchez L, Pérez-Viejo E, Serrano Á, Martínez-Torres B. Treatment of Peritoneal Surface Malignancies by Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Spain: Results of the National Registry of the Spanish Group of Peritoneal Oncologic Surgery (REGECOP). J Clin Med 2023;12:3774. [PMID: 37297969 PMCID: PMC10253421 DOI: 10.3390/jcm12113774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open

Abstract

INTRODUCTION

Treatment of Peritoneal Surface Malignancies (PSM) with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has achieved results never seen before in these patients, which classically have a poor prognosis. The possibility of conducting clinical trials in these diseases is complicated, since some of them are rare, so the analysis of large databases provides very valuable scientific information. The aim of this study is to analyze the global results of the National Registry of the Spanish Group of Peritoneal Oncologic Surgery (REGECOP), whose objective is to register all patients scheduled for HIPEC nationwide.

METHODS

This is a retrospective analysis of the data recorded in the REGECOP from 36 Spanish hospitals from 2001 to 2021. There were 4159 surgical interventions in 3980 patients.

RESULTS

66% are women and 34% are men with a median age of 59 years (range 17-86). 41.5% of the patients were treated for Peritoneal Metastases (PM) of colorectal cancer (CRC); 32.4% were women with ovarian cancer (OC) with PM; 12.8% were treated for pseudomyxoma peritonei (PMP); 6.2% had PM from gastric cancer (GC); 4.9% had PM of non-conventional origin; and, finally, 2.1% of cases were patients diagnosed with peritoneal mesothelioma. The median Peritoneal Cancer Index (PCI) was 9 (0-39), and complete cytoreduction was achieved in 81.7% of the procedures. Severe morbidity (Dindo-Clavien grade III-IV) was observed in 17.7% of surgeries, with 2.1% mortality. Median hospital stay was 11 days (0-259). Median overall survival (OS) was 41 months for CRC patients, 55 months for women with OC, was not reached in PMP patients, was 14 months for GC patients, and 66 months in mesothelioma patients.

CONCLUSIONS

large databases provide extremely useful data. CRS with HIPEC in referral centers is a safe treatment with encouraging oncologic results in PSM.

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Affiliation(s)

Israel Manzanedo Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (F.P.); (E.P.-V.); (Á.S.); (B.M.-T.) Department of Surgery, Rey Juan Carlos University (URJC), 28933 Madrid, Spain Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.)
Fernando Pereira Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (F.P.); (E.P.-V.); (Á.S.); (B.M.-T.) Department of Surgery, Rey Juan Carlos University (URJC), 28933 Madrid, Spain Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.)
Pedro Cascales-Campos Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Peritoneal Oncologic Surgery Unit, Department of Surgery, Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain
Cristobal Muñoz-Casares Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of Surgery, Hospital Virgen del Rocío, 41013 Sevilla, Spain
Enrique Asensio Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Advanced Oncologic Surgery Unit, Department of General and Digestive Surgery, Hospital Río Hortega, 47012 Valladolid, Spain
Juan Torres-Melero Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital Universitario de Torrecárdenas, 04009 Almería, Spain
Arancha Prada-Villaverde Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital Infanta Cristina, 06080 Badajoz, Spain
Ibán Caravaca-García Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital General Universitario de Elche, 03203 Alicante, Spain
Alberto Gutiérrez-Calvo Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital Príncipe de Asturias de Alcalá de Henares, 28805 Madrid, Spain
Javier Vaqué Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital de La Fe, 46026 Valencia, Spain
Gloria Ortega Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital MD Anderson Cancer Center, 28033 Madrid, Spain
Alberto Titos-García Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
Laura González-Sánchez Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.) Department of General and Digestive Surgery, Hospital Insular, 35016 Las Palmas de Gran Canaria, Spain
Estíbalitz Pérez-Viejo Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (F.P.); (E.P.-V.); (Á.S.); (B.M.-T.) Department of Surgery, Rey Juan Carlos University (URJC), 28933 Madrid, Spain Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.)
Ángel Serrano Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (F.P.); (E.P.-V.); (Á.S.); (B.M.-T.) Department of Surgery, Rey Juan Carlos University (URJC), 28933 Madrid, Spain Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.)
Beatriz Martínez-Torres Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (F.P.); (E.P.-V.); (Á.S.); (B.M.-T.) Department of Surgery, Rey Juan Carlos University (URJC), 28933 Madrid, Spain Spanish Group of Peritoneal Oncologic Surgery (GECOP), 28001 Madrid, Spain; (P.C.-C.); (C.M.-C.); (E.A.); (J.T.-M.); (A.P.-V.); (I.C.-G.); (A.G.-C.); (J.V.); (G.O.); (A.T.-G.); (L.G.-S.)
REGECOP Group

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Lago V, Segarra-Vidal B, Cappucio S, Angeles MA, Fotopoulou C, Muallem MZ, Manzanedo I, Iglesias JLS, Chacón E, Padilla-Iserte P, Fagotti A, Ferron G, Kluge L, Vargiu V, Del M, Scambia G, Minig L, Tejerizo Á, Segovia MG, Cascales-Campos PA, Hervás D, Domingo S. OVA-LEAK: Prognostic score for colo-rectal anastomotic leakage in patients undergoing ovarian cancer surgery. Gynecol Oncol 2022;167:22-27. [PMID: 36058743 DOI: 10.1016/j.ygyno.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/31/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022]

Abstract

OBJECTIVE

The objective of the present study was to define and validate an anastomotic leak prognostic score based on previously described and reported anastomotic leak risk factors (OVA-LEAK: https://n9.cl/ova-leakscore) and to establish if the use of OVA-LEAK score is better than clinical criteria (surgeon's choice) selecting anastomosis to be protected with a diverting ileostomy.

MATERIAL & METHODS

This is a retrospective, multicentre cohort study that included patients who underwent cytoreductive surgery for primary advanced or relapsed ovarian cancer with colorectal resection and anastomosis between January 2011 and June 2021. Data from patients already included in the previous predictive model were not considered in the present analysis. To validate the performance of our logistic regression model, we used the OVA-LEAK formula (Annex I: https://n9.cl/ova-leakscore) for estimating leakage probabilities in a new independent cohort. Then, receiver operating characteristic (ROC) analysis was performed and area under the curve (AUC) was used to measure the performance of the model. Additionally, the Brier score was also estimated. 95% confidence intervals (CI) for each of the estimated performance measures were also calculated.

RESULTS

848 out of 1159 recruited patients were finally included in the multivariable logistic regression model validation. The AUC of the new cohort was 0.63 for predicting anastomotic leak. Considering a cut-off point of 22.1% to be 'positive' (to get a leak) this would provide a sensitivity of 0.45, specificity of 0.80, positive predictive value of 0.09 and negative predictive value of 0.97 for anastomotic leak. If we consider this cut-off point to select patients at risk of leak for bowel diversion, up to 22.5% of the sampled patients would undergo a diverting ileostomy and 47% (18/40) of the anastomotic leaks would be 'protected' with the stoma. Nevertheless, if we consider only the 'clinical criteria' for performing or not a diverting ileostomy, only 12.5% (5/40) of the leaks would be 'protected' with a stoma, with a rate of diverting ileostomy of up to 24.3%.

CONCLUSIONS

Compared with subjective clinical criteria, the use of a predictive model for anastomotic leak improves the selection of patients who would benefit from a diverting ileostomy without increasing the rate of stoma use.

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Affiliation(s)

Víctor Lago Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain; CEU Cardenal Herrera, Spain.
Blanca Segarra-Vidal Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain
Serena Cappucio Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
Martina Aida Angeles Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
Christina Fotopoulou Department of Gynecologic Oncology, Imperial College London, London, United Kingdom
Mustafa Zelal Muallem Department of Gynecology with Centre for Oncological Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
Israel Manzanedo Department of General and Digestive Surgery, Peritoneal Carcinomatosis Unit, Hospital Universitario de Fuenlabrada, Madrid, Spain
Jose Luis Sanchez Iglesias Department of Obstetrics and Gynecology, Vall d'Hebron, Barcelona, Spain
Enrique Chacón Department of Obstetrics and Gynecology, University Clinic of Navarra, Madrid, Navarre, Spain
Pablo Padilla-Iserte Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain
Anna Fagotti Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
Gwenael Ferron Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
Luisa Kluge Department of Gynecology with Centre for Oncological Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
Virginia Vargiu Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
Mathilde Del Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
Giovanni Scambia Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
Lucas Minig Department of Gynecology, IMED Hospitales, Valencia, Spain
Álvaro Tejerizo Department of Obstetrics and Gynecology, Hospital 12 de Octubre, Madrid, Spain
Myriam García Segovia Gynaecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
Pedro Antonio Cascales-Campos Department of General Surgery, Virgen de la Arrixaca Clinic and University Hospital, Murcia, Spain

David Hervás Department of Applied Statistics and Operational Research and Quality, Universitat Politècnica de València, Valencia, Spain
Santiago Domingo Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain

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Pereira F, Serrano A, Manzanedo I, Pérez-Viejo E, González-Moreno S, González-Bayón L, Arjona-Sánchez A, Torres J, Ramos I, Barrios ME, Cascales P, Morales R, Boldó E, García-Fadrique A, Arteaga X, Gutierrez-Calvo A, Sánchez-García S, Asensio E, Ramírez CP, Artiles M, Vaqué J, Parra PA, Villarejo P, Muñoz-Casares C, Turienzo E, Calero A, Torrejimeno IJ, Prieto I, Galindo J, Borrego V, Marcello ME, Rihuete C, Carrasco J, Gomez-Quiles L. GECOP-MMC: phase IV randomized clinical trial to evaluate the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) with mytomicin-C after complete surgical cytoreduction in patients with colon cancer peritoneal metastases. BMC Cancer 2022;22:536. [PMID: 35549912 PMCID: PMC9097342 DOI: 10.1186/s12885-022-09572-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/19/2022] [Indexed: 12/21/2022] Open

Abstract

BACKGROUND

The French PRODIGE 7 trial, published on January 2021, has raised doubts about the specific survival benefit provided by HIPEC with oxaliplatin 460 mg/m² (30 minutes) for the treatment of peritoneal metastases from colorectal cancer. However, several methodological flaws have been identified in PRODIGE 7, specially the HIPEC protocol or the choice of overall survival as the main endpoint, so its results have not been assumed as definitive, emphasizing the need for further research on HIPEC. It seems that the HIPEC protocol with high-dose mytomicin-C (35 mg/m²) is the preferred regime to evaluate in future clinical studies.

METHODS

GECOP-MMC is a prospective, open-label, randomized, multicenter phase IV clinical trial that aims to evaluate the effectiveness of HIPEC with high-dose mytomicin-C in preventing the development of peritoneal recurrence in patients with limited peritoneal metastasis from colon cancer (not rectal), after complete surgical cytoreduction. This study will be performed in 31 Spanish HIPEC centres, starting in March 2022. Additional international recruiting centres are under consideration. Two hundred sixteen patients with PCI ≤ 20, in which complete cytoreduction (CCS 0) has been obtained, will be randomized intraoperatively to arm 1 (with HIPEC) or arm 2 (without HIPEC). We will stratified randomization by surgical PCI (1-10; 11-15; 16-20). Patients in both arms will be treated with personalized systemic chemotherapy. Primary endpoint is peritoneal recurrence-free survival at 3 years. An ancillary study will evaluate the correlation between surgical and pathological PCI, comparing their respective prognostic values.

DISCUSSION

HIPEC with high-dose mytomicin-C, in patients with limited (PCI ≤ 20) and completely resected (CCS 0) peritoneal metastases, is assumed to reduce the expected risk of peritoneal recurrence from 50 to 30% at 3 years.

TRIAL REGISTRATION

EudraCT number: 2019-004679-37; Clinicaltrials.gov: NCT05250648 (registration date 02/22/2022, ).

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Affiliation(s)

Fernando Pereira Hospital Universitario de Fuenlabrada, Camino del Molino 2, Fuenlabrada, 28942, Madrid, Spain.
Angel Serrano Hospital Universitario de Fuenlabrada, Camino del Molino 2, Fuenlabrada, 28942, Madrid, Spain
Israel Manzanedo Hospital Universitario de Fuenlabrada, Camino del Molino 2, Fuenlabrada, 28942, Madrid, Spain
Estibalitz Pérez-Viejo Hospital Universitario de Fuenlabrada, Camino del Molino 2, Fuenlabrada, 28942, Madrid, Spain
Santiago González-Moreno MD Anderson Cancer Center, Calle de Arturo Soria 270, 28033, Madrid, Spain
Luis González-Bayón Hospital General Universitario Gregorio Marañón, C/ Doctor Esquerdo, 46 -, 28007, Madrid, Spain
Alvaro Arjona-Sánchez Hospital Universitario Reina Sofía, Avda. Menendez Pidal s/n, 14004, Córdoba, Spain
Juan Torres Hospital Universitario Torrecárdenas, Calle Hermandad de Donantes de Sangre s/n, 04009, Almería, Spain
Isabel Ramos Hospital Sant Joan Despi Moises Broggi, Carrer de Jacint Verdaguer, 90, 08970 Sant Joan Despí, Barcelona, Spain
Maria E Barrios Hospital Clinico Universitario de Valencia, Avenida de Blasco Ibañez, 17, 46010, Valencia, Spain
Pedro Cascales Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Murcia, Spain
Rafael Morales Hospital Universitario Son Espases, Carretera de Valldemossa, 79. 07210 Palma, Mallorca, Spain
Enrique Boldó Consorcio Hospitalario Provincial De Castellón, Avenida del Doctor Clarà 19, 12006, Castellón de la Plana, Spain
Alfonso García-Fadrique Instituto Valenciano de Oncología, C/ Prof. Beltrán Báguena, 8 -, 46009, Valencia, Spain
Xabier Arteaga Hospital Universitario Donostia, Begiristain Doktorea Pasealekua 109, 20014, Donostia, Gipuzkoa, Spain
Alberto Gutierrez-Calvo Hospital Universitario Principe de Asturias, Carretera Alcalá-Meco, s/n - 28805 Alcalá de Henares, Madrid, Spain
Susana Sánchez-García Hospital General Universitario de Ciudad Real, C/ Obispo Rafael Torija s/n - Pol. Larache, 13005, Ciudad Real, Spain
Enrique Asensio Hospital Universitario Río Hortega, Calle Dulzaina, 2, 47012, Valladolid, Spain
Cesar P Ramírez Hospital Quirónsalud Málaga, Avenida de Imperio Argentina, 1, 29004, Málaga, Spain
Manuel Artiles Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena, 0, 35010, Las Palmas de Gran Canaria, Spain
Javier Vaqué Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
Pedro A Parra Hospital General Universitario Reina Sofía, Avda. Intendente Jorge Palacios, 1, 30003, Murcia, Spain
Pedro Villarejo Fundación Jiménez Díaz, Avda. Reyes Católicos 2, 28040, Madrid, Spain
Cristóbal Muñoz-Casares Hospital Universitario Virgen del Rocío, Avda de Manuel Siurot s/n, 41013, Sevilla, Spain
Estrella Turienzo Hospital Universitario Central de Asturias, Avenida de Roma, 0, 33011, Oviedo, Spain
Alicia Calero Hospital General Universitario de Elche, Camí de la Almazara, 11, 03203 Elche, Alicante, Spain
Isabel Jaén Torrejimeno Complejo Hospitalario Universitario de Badajoz, Av. de Elvas, s/n, 6080, Badajoz, Spain
Isabel Prieto Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
Julio Galindo Hospital Universitario Ramón y Cajal, Ctra. de Colmenar Viejo km. 9,100, 28034, Madrid, Spain
Vicente Borrego Hospital Clínico Universitario "Lozano Blesa", Avda. San Juan Bosco, 15, 50009, Zaragoza, Spain
Manuel E Marcello Hospital Universitario Fundación Alcorcón, Calle de Budapest, 1, 28922 Alcorcón, Madrid, Spain
Cristina Rihuete Hospital Universitario Infanta Elena, Avenida de los Reyes Católicos 21, 28340 Valdemoro, Madrid, Spain
Joaquin Carrasco Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82-88, 29010, Málaga, Spain
Luis Gomez-Quiles Hospital General Universitario De Castellón, Avenida de Benicassim, 128, 12004, Castellón, Spain

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Manzanedo I, Pereira F, Serrano Á, Pérez-Viejo E. Review of management and treatment of peritoneal metastases from gastric cancer origin. J Gastrointest Oncol 2021;12:S20-S29. [PMID: 33968423 DOI: 10.21037/jgo-20-232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open

Gutierrez A, Gómes R, Pereira F, Manzanedo I, García E, Sánchez S, López-Tomassetti E, González L, Fabra I, Titos A, Marcello ME, Calero A, Rufián B, Cascales PA, Villarejo P. Morbimortality of Patients Undergoing Cytoreduction + Closed Hipec with Co2 Agitation System: A Multicentre Study. Eur J Surg Oncol 2020. [DOI: 10.1016/j.ejso.2019.11.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open

Navarro-Barrios Á, Gil-Martínez J, Ramos-Bernardo I, Barrios P, Muñoz-Casares C, Torres-Melero J, Pereira F, Manzanedo I, Arjona Á, Martínez-Regueira F, Cascales-Campos PA. Intraperitoneal hyperthermic chemotherapy after cytoreduction in patients with peritoneal metastases from endometrial cancer. The next frontier? Surg Oncol 2019;33:19-23. [PMID: 32561085 DOI: 10.1016/j.suronc.2019.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/25/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]

Abstract

BACKGROUND

Endometrial cancer is the most common malignancy of the female genital tract. For cancers detected at an advanced stage or intraperitoneal relapse, the prognosis is poor. Optimal cytoreductive surgery (CRS) is the most accepted treatment; however, patients with advanced intraperitoneal disease might benefit from hyperthermic intraoperative peritoneal chemotherapy (HIPEC). The aim of this study was to analyze recurrence-free survival (RFS) after CRS and HIPEC in a large series of patients with peritoneal metastases from endometrial cancer.

METHODS

Patients with a diagnosis of endometrial cancer with primary or recurrent peritoneal dissemination were included. All patients underwent CRS plus HIPEC. Data were prospectively collected in the Spanish Group of Peritoneal Oncological Surgery (GECOP) database.

RESULTS

Forty-three patients with endometrial cancer and peritoneal metastasis were included. Fifteen patients (35%) were diagnosed with G3 endometrioid carcinomas and 28 (65%) with other non-endometroid histologies. A completeness of cytoreduction score of CC-0 was achieved in 41 patients (95%). RFS at 5 years was 23%, being factors related to worse RFS: treatment with preoperative chemotherapy (p = 0.027), resection of more than three peritoneal areas (p = 0.010), cytoreduction of the upper abdominal space (p = 0.023), HIPEC treatment with paclitaxel (p = 0.013), and the presence of metastatic lymph nodes (p = 0.029).

CONCLUSIONS

Better RFS rates after CRS and HIPEC were observed for patients with the following characteristics: cytoreductive surgery without preoperative chemotherapy, complete surgery performed with limited surgical maneuvers, treated with cisplatin, and no lymph node metastases.

SYNOPSIS

Endometrial cancer has a poor prognosis when diagnosed at advance stage. Patients with intraperitoneal metastases from endometrial cancer may benefit from CRS plus HIPEC with improvement in the recurrence-free survival results.

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Manzanedo I, Pereira F. ASO Author Reflections: Current Status of Treatment of Peritoneal Carcinomatosis from Gastric Cancer Origin in Spain: Is It Possible to Cure These Patients? Ann Surg Oncol 2019;26:792-793. [PMID: 31628556 DOI: 10.1245/s10434-019-07952-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Indexed: 11/18/2022]

Manzanedo I, Pereira F, Rihuete Caro C, Pérez-Viejo E, Serrano Á, Gutiérrez Calvo A, Regueira FM, Casado-Adam Á, Cascales-Campos PA, Arteaga X, García-Fadrique A, Gómez Sanz R, López García A, Zozaya G, Arjona Á, Gil Martínez J. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Gastric Cancer with Peritoneal Carcinomatosis: Multicenter Study of Spanish Group of Peritoneal Oncologic Surgery (GECOP). Ann Surg Oncol 2019;26:2615-2621. [DOI: 10.1245/s10434-019-07450-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Indexed: 12/16/2022]

Calvo AG, Gomez R, Lopez A, Sanchez S, Villarejo P, Padilla D, Manzanedo I, Pereira F, Perez-Viejo E, Gonzalez L, Lopez-Tomassetti E, Hernandez J, Diaz E, Fabra I, Titos A, Pitarch M, Ochando F, Lacueva F. Morbimortality of patients undergoing cytoreduction + closed hipec with co2 agitation system: a multicentre study. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open

Calvo AG, Gomez R, Lasa I, Sanchez S, Padilla D, Villarejo P, Manzanedo I, Pereira F, Perez-Viejo E, Gonzalez L, Lopez-Tomassetti E, Hernandez J, Fabra I, Diaz E, Titos A, Pitarch M, Marcello M, Lacueva F. Analysis of the survival of patients undergoing cytoreduction + closed hipec with co2 agitation system: multicenter study. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open

Manzanedo I, Losada B, Martínez-Torres B, Pereira F, Serrano Á, Juez I, Pérez-Viejo E, Gutiérrez D, Peiró V, Aulló C. Validation of diagnostic methods for peritoneal carcinomatosis secondary to ovarian cancer. CT-scan, PET-CT or laparoscopy, what is the best? Minerva Obstet Gynecol 2018;70:488-490. [PMID: 29431339 DOI: 10.23736/s0026-4784.18.04182-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]

Affiliation(s)

Israel Manzanedo Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain - .,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain - .,Rey Juan Carlos University (URJC), Madrid, Spain -
Beatriz Losada Rey Juan Carlos University (URJC), Madrid, Spain.,Department of Medical Oncology, Fuenlabrada University Hospital, Madrid, Spain
Beatriz Martínez-Torres Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
Fernando Pereira Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
Ángel Serrano Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
Ignacio Juez Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain.,Department of Medical Oncology, Fuenlabrada University Hospital, Madrid, Spain
Estíbalitz Pérez-Viejo Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
David Gutiérrez Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Department of Medical Oncology, Fuenlabrada University Hospital, Madrid, Spain
Virginia Peiró Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Department of Nuclear Medicine, Fuenlabrada University Hospital, Madrid, Spain
Carolina Aulló Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Department of Radiology, Fuenlabrada University Hospital, Madrid, Spain

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Manzanedo I, Pereira F, Pérez-Viejo E, Serrano Á, Hernández-García M, Martínez-Torres B, Rihuete-Caro C, Calzas J, Cueto M. Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) with primary or secondary cytoreductive surgery in the treatment of advanced epithelial ovarian cancer. Minerva Obstet Gynecol 2016;69:119-127. [PMID: 27415829 DOI: 10.23736/s0026-4784.16.03959-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]