Unit:
Κατεύθυνση Χειρουργική ΝοσηλευτικήLibrary of the School of Health Sciences
Author:
Pitarokoilis Nikolaos
Supervisors info:
Θεοδοσοπούλου Ελένη ,Καθηγήτρια ,Νοσηλευτική Σχολή, ΕΚΠΑ
Τσουμάκας Κωσταντίνος , Καθηγητής ,Νοσηλευτική Σχολή, ΕΚΠΑ
Μαριόλης-Σαψάκος Θεόδωρος , Αναπληρωτής Καθηγητής ,Νοσηλευτική Σχολή, ΕΚΠΑ
Original Title:
Η χρήση της διεγχειρητικής ενδοπεριτοναϊκής χημειοθεραπείας σε ασθενείς με περιτοναϊκή καρκινωμάτωση. Προγνωστικοί παράγοντες και έκβαση της νόσου.
Translated title:
The use of intraoperative intraperitoneal chemotherapy on patients with peritoneal carcinomatosis.Prognostic factors and outcome of the disease.
Summary:
Background: Peritoneal carcinomatosis is a nosological entity that was previously considered as a terminal disease and for which there was no radical cure Purpose: To investigate the use of intraoperative intraperitoneal chemotherapy in peritoneal carcinomatosis in relation to the outcome of the disease after its administration as well as the search for prognostic factors of outcome. Method: There were essentially three systematic reviews of the literature conducted in the electronic databases Medline, Scopus, and Cochrane for the period 2015-2020. The following terms based on MeSH vocabulary was used for searches, for the first: "predictive factors" OR "prognostic factors" AND "peritoneal carcinomatosis", for the second: "cytoreductive surgery" OR "CRS" AND "hyperthermic Intraperitoneal chemotherapy" OR "HIPEC "AND" peritoneal carcinomatosis "and for the third:" pressurized intraperitoneal chemotherapy "OR" pipac "AND" peritoneal carcinomatosis ". Criteria for inclusion of the articles were English language, their research design, the sample consisting of more than 10 patients and the thematic focus on the prognostic factors of the outcome of peritoneal disease or the outcome of the disease. Finally, the sample consisted of 14 retrospective and prospective studies for the part concerning the prognostic factors and for the part concerning the outcome of the disease 37 retrospective and prospective studies. Results: The main prognostic factors found mainly concern the adequacy of cytoreduction, the peritoneal carcinoma index (PCI), and whether infiltrated lymph nodes will coexist in the detection of the disease, facts that, if applicable, make it difficult for the treatment and survival of the patient. Regarding the outcome of the disease, it was found that the use of intraoperative intraperitoneal chemotherapy, when administered hyperthermically, offers an extension of the survival period and the period of disease free as well as when administered in the form of a pressure aerosol offers a positive objective tumor response and reduction of ascites fluid in comparison with classical methods of treatment. Conclusion: It is concluded that the use of intraoperative intraperitoneal chemotherapy is a therapeutic approach for patients with peritoneal disease that can give them hope and provide them with benefits. However, what must be understood and applied universally is that, especially for those who are scheduled to receive CRS-HIPEC, the proper choice of patients to receive this treatment must be made and it must be applied in specialized centers with experience on this method and by experienced staff. Further randomized clinical trials are needed to support this view.
Main subject category:
Health Sciences
Keywords:
Peritoneal carcinomatosis,Prognostic factors,Cytoreductive surgery,Intraperitoneal chemotherapy
Number of references:
153
