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Author: Marc A. Reymond Publisher: Walter de Gruyter GmbH & Co KG ISBN: 3110386364 Category : Medical Languages : en Pages : 249
Book Description
Peritoneal dissemination is a common route of cancer metastasis. The benefit of administering chemotherapy directly into the peritoneal cavity is supported by preclinical and pharmacokinetic data. In comparison to intravenous (IV) treatment, intraperitoneal (IP) administration results in a several-fold increase in drug concentration within the abdominal cavity. There is now growing evidence from clinical studies showing a survival advantage for IP chemotherapy in various tumor typies, including ovarian, gastric and colorectal cancer. However, while the use of IP chemotherapy is slowly gaining acceptance, it is not universal, largely due to the greater toxicity associated with this approach. Moreover, efficacy of IP chemotherapy is limited by poor distribution within the abdominal cavity and by poor tissue penetration. A new way of IP chemotherapy is the application of cytotoxics in form of a pressurized aerosol into the abdominal of thoracic cavity. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is applied through laparoscopic access using two balloon trocars in an operating room equipped with laminar air-flow. In a first step,a normothermic capnoperitoneum is established with a pressure of 12 mmHg. A cytotoxic solution (about 10% of a normal systemic dose) is nebulized with a micropump into the abdominal cavity, and maintained for 30 min. The aerosol is then removed through a closed suction system. Applying an aerosol in the peritoneal cavity allows a homogeneous distribution of the chemotherapeutic agent within the abdomen. Furthermore, an artificial pressure gradient is generated that overcomes tumoral interstitial fluid pressure, an obstacle in cancer therapy. This results in a higher local drug concentration compared to conventional IP or IV chemotherapy. At the same time the plasma concentration of the chemotherapeutic agent remains low. In first clinical studies with limited number of patients in ovarian, gastric and colorectal cancer, as well as peritoneal mesothelioma, PIPAC has obtained encouraging tumor response rates and survival, with a low-side effects profile. Larger clinical trials are currently ongoing to examine if these data can be reproduced and extrapolated to other situations.
Author: Marc A. Reymond Publisher: Walter de Gruyter GmbH & Co KG ISBN: 3110386364 Category : Medical Languages : en Pages : 249
Book Description
Peritoneal dissemination is a common route of cancer metastasis. The benefit of administering chemotherapy directly into the peritoneal cavity is supported by preclinical and pharmacokinetic data. In comparison to intravenous (IV) treatment, intraperitoneal (IP) administration results in a several-fold increase in drug concentration within the abdominal cavity. There is now growing evidence from clinical studies showing a survival advantage for IP chemotherapy in various tumor typies, including ovarian, gastric and colorectal cancer. However, while the use of IP chemotherapy is slowly gaining acceptance, it is not universal, largely due to the greater toxicity associated with this approach. Moreover, efficacy of IP chemotherapy is limited by poor distribution within the abdominal cavity and by poor tissue penetration. A new way of IP chemotherapy is the application of cytotoxics in form of a pressurized aerosol into the abdominal of thoracic cavity. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is applied through laparoscopic access using two balloon trocars in an operating room equipped with laminar air-flow. In a first step,a normothermic capnoperitoneum is established with a pressure of 12 mmHg. A cytotoxic solution (about 10% of a normal systemic dose) is nebulized with a micropump into the abdominal cavity, and maintained for 30 min. The aerosol is then removed through a closed suction system. Applying an aerosol in the peritoneal cavity allows a homogeneous distribution of the chemotherapeutic agent within the abdomen. Furthermore, an artificial pressure gradient is generated that overcomes tumoral interstitial fluid pressure, an obstacle in cancer therapy. This results in a higher local drug concentration compared to conventional IP or IV chemotherapy. At the same time the plasma concentration of the chemotherapeutic agent remains low. In first clinical studies with limited number of patients in ovarian, gastric and colorectal cancer, as well as peritoneal mesothelioma, PIPAC has obtained encouraging tumor response rates and survival, with a low-side effects profile. Larger clinical trials are currently ongoing to examine if these data can be reproduced and extrapolated to other situations.
Author: Amine Souadka Publisher: Frontiers Media SA ISBN: 2832546706 Category : Medical Languages : en Pages : 130
Book Description
Peritoneal surface malignancies (PSM) include a heterogeneous group of primary tumors, like peritoneal mesothelioma, and peritoneal metastases from various origins such as ovarian, gastric, colorectal, or appendicular cancers. Their pathophysiology is complex and still not fully elucidated. Historically, due to their dismal prognosis, peritoneal surface malignancies were considered a terminal condition and treated as such in palliative intent.. Surgery has become pivotal in the treatment of PSM and the development of specific techniques of cytoreductive surgery (peritonectomies, “en-bloc” resection) open up a new era of curative intent treatments.
Author: Yuman Fong Publisher: Springer Nature ISBN: 3030288919 Category : Medical Languages : en Pages : 490
Book Description
This book is a state-of-the-art overview of cancer regional therapy (CRT) for the surgeons and interventional radiologists active in CRT development and research. The goals of this book are 1) to review the theory and practice of cancer regional therapies including pharmacology, devices, techniques, and workflow, 2) illustrate the most common procedures performed in the interventional and operating rooms, and 3) discuss data supporting use of CRT. This is meant to be a definitive text on the theory and practice of CRT. It begins with a summary of the history, technical principles that underlie regional therapy. The following parts discuss current data and practice in peritoneal, liver, limb, pleural and other sites. Included in the practice are considerations of workflow and financial issues revolving around CRT. Novel techniques and therapies under investigation are presented to inform the direction of the field. Cancer Regional Therapy summarizes the history, current technology, common procedures, and future prospects in this field and includes procedures from many surgical and interventional radiologic disciplines.
Author: Beate Rau Publisher: Springer Nature ISBN: 3030626407 Category : Medical Languages : en Pages : 407
Book Description
This book provides surgeons and oncologists with a well-founded and detailed overview of the available treatment options for peritoneal malignancy and differential selection of the appropriate forms of therapy. Systemic chemotherapy options are also considered, as are surgical cytoreduction (CRS) and all forms of intraperitoneal chemotherapy (IPC) especially hyperthermic IPC (HIPEC), and immunotherapy, including specific procedures such as PIPAC. Subsequent chapters address perioperative care, complications and recurrences, as well as psycho-oncological, palliative medical and nursing care. The process of parietal and visceral peritonectomy in the large and small intestine is additionally illustrated by three video clips accessible online. Covering a broad range of aspects, including peritoneal metastasis and intraperitoneal chemotherapy, the book offers a valuable tool for surgeons, oncologists and anesthesiologists alike.
Author: Paul H. Sugarbaker Publisher: Springer Science & Business Media ISBN: 1461312477 Category : Medical Languages : en Pages : 434
Book Description
Paul Sugarbaker and his colleagues have persevered in the study and treat ment of peritoneal carcinomatosis. The peritoneal cavity has many unique and incompletely appreciated properties. These properties, coupled with the biologic behavior of many cancers, results in the seeding and growth of these cancers on the peritoneum. Many of these cancers remain localized to the peritoneum only, never metastasizing to other sites. One possible reason for this may be the obstruction of the afferent lymphatics on the undersurface of the diaphragm. The mucopolysaccharides produced by many of these neoplasma are probably viscous enough to obstruct these lymphatics, leading to the syndrome of pseudomyxoma peritonei. Many of the neoplasms taking residence on the peritoneum have extremely long cell-cycle times and are resistant to radiotherapy and many chemotherapeutic agents. How ever, much can be done for these patients - resection of primary cancers, omentectomies to reduce ascites formation, management of recurrent ascites, management of intestinal obstruction, nutritional care, and, hopefully, intraperitoneal chemotherapy. We have reviewed many of these problems in the past [1-7]. Dr. Sugarbaker and his colleagues have organized the current state of knowledge and technology for continuing use. The book provides a basis for thoughtful, prospective research planning. John S. Spratt, M. D. , F. A. C. S. Professor of Surgery The James Graham Brown Cancer Center University of Louisville Louisville, Kentucky References 1. Long RTL, Spratt JS, Dowling E.
Author: Desmond C. Winter Publisher: John Wiley & Sons ISBN: 1119518407 Category : Medical Languages : en Pages : 324
Book Description
An innovative guide to the practice of pelvic exenterative surgery for the management of advanced pelvic neoplasms Exenterative surgery plays an important role in the management of advanced pelvic cancer. However, while a large body of evidence regarding outcomes following pelvic exenteration now exists, practical strategies and management options remain unclear. Surgical Management of Advanced Pelvic Cancer addresses this problem by assembling world-leaders in the field to provide insights into the latest techniques and best practices. It includes detailed coverage of: Surgical anatomy Operative approaches and exenterative techniques Reconstruction options Current evidence on survival and quality of life outcomes Featuring essential information for those managing patients with advanced pelvic neoplasms, Surgical Management of Advanced Pelvic Cancer consolidates the latest data and practical advice in one indispensable guide.
Author: Wim P. Ceelen Publisher: CRC Press ISBN: 1482261197 Category : Medical Languages : en Pages : 423
Book Description
Intraperitoneal Cancer Therapy: Principles and Practice is one of the first books to combine the latest clinical developments in the treatment of patients with peritoneal surface disease and the scientific principles that underlie the concept of intraperitoneal cancer therapy. The book covers basic concepts such as anatomy, physiology, pharmacology
Author: Giovanni de Manzoni Publisher: Springer Nature ISBN: 3030731588 Category : Medical Languages : en Pages : 276
Book Description
Twenty-five years ago, a monograph on gastric cancer was published by the Italian Society of Surgery: that book is recognized as a milestone in the management of these tumors in Italy. Oncological and surgical knowledge in the field of gastric cancer have changed dramatically over the last 25 years. The aim of this book is to offer an essential update on current diagnostic approaches and optimal treatment strategies. It gives comprehensive information on gastric cancer not neglecting the basic sciences, which can shed light on the carcinogenesis mechanisms involved in this pathology. The principles of tailored and multimodal treatment are examined according to the latest guidelines with the aim of providing a valuable synopsis for clinicians. The book not only reviews what has changed in the field of gastric cancer over the past quarter century but also offers the reader a glimpse of the future by describing the ongoing surgical and oncological trials which focus on new treatment frontiers such as immunotherapy and target therapy. It also seeks to incorporate the latest discoveries based on molecular classifications. Further, the book reflects the findings and experiences of Italian experts belonging to the GIRCG (Italian Research Group for Gastric Cancer) and will offer an excellent guide for oncological surgeons in their daily practice of caring for patients affected by gastric cancer.
Author: Fernando López Mozos Publisher: Nova Science Publishers ISBN: 9781536196023 Category : Medical Languages : en Pages : 270
Book Description
"Gastric cancer is the fourth most common cancer in the world. Most gastric cancers are diagnosed in advanced stages, and the prognosis remains poor. The 5-year survival rate is 40-60% in eastern countries and around 25% in the west. Among advanced gastric cancer cases, peritoneal implantation is one of the most common forms of metastasis and around 14% of cases present peritoneal metastases at initial diagnosis, presenting a survival of 3-6 months. Until the early 1990s it was considered a terminal disease. But today these patients have some opportunities to be treated with curative intent or to prolong their life. Although the prognosis remains poor, there are some treatment options including cytoreductive surgery, neoadjuvant therapy, and some forms of intraperitoneal chemotherapy with or without hyperthermia. These are aggressive treatments, so we must be careful when selecting patients. Imaging and preoperative staging are also crucial in selecting patients for appropriate treatment. The surgical technique is described and a detailed demonstration video is available in the e-book version. New forms of treatment such as PIPAC and new scientific advances and future perspectives are discussed. This book is an update on this topic and attempts to provide an overview for all medical personnel involved in the treatment of these patients"--
Author: Marc A. Reymond
Author: Marc A. Reymond
Author: Amine Souadka
Author: Yuman Fong
Author: Beate Rau
Author: Paul H. Sugarbaker
Author: Desmond C. Winter
Author: Wim P. Ceelen
Author: Giovanni de Manzoni
Author: Fernando López Mozos
Author: Indian Agricultural Research Institute