Gastrointestinal Oncology

Annals of Surgical Oncology

, Volume 21, Issue 5, pp 1501-1505

Consensus Guidelines from The American Society of Peritoneal Surface Malignancies on Standardizing the Delivery of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Colorectal Cancer Patients in the United States

  • K. TuragaAffiliated withMedical College of Wisconsin
  • , E. LevineAffiliated withWake Forest University Baptist Medical Center
  • , R. BaroneAffiliated withSharp Health Care
  • , R. SticcaAffiliated withUniversity of North Dakota
  • , N. PetrelliAffiliated withChristiana Care Health System
  • , L. LambertAffiliated withUMass Memorial Medical Center
  • , G. NashAffiliated withMemorial Sloan-Kettering Cancer Center
  • , M. MorseAffiliated withDuke University
  • , R. Adbel-MisihAffiliated withChristiana Care Health System
    • , H. R. AlexanderAffiliated withUniversity of Maryland Medical Center
    • , F. AttiyehAffiliated withMedical College of WisconsinSt. Luke’s-Roosevelt Hospital Center
    • , D. BartlettAffiliated withMedical College of WisconsinUniversity of Pittsburgh
    • , A. BastidasAffiliated withMedical College of WisconsinNational Surgical Associates
    • , T. BlazerAffiliated withDuke University
    • , Q. ChuAffiliated withMedical College of WisconsinLouisiana State University Health Sciences Center
    • , K. ChungAffiliated withMemorial Sloan-Kettering Cancer Center
    • , L. Dominguez-ParraAffiliated withMedical College of WisconsinHospital Regional De Alta Especialidad De La Yucatan
    • , N. J. EspatAffiliated withMedical College of WisconsinRoger Williams Medical Center
    • , J. FosterAffiliated withMedical College of WisconsinUniversity of Nebraska Medical Center
    • , K. FournierAffiliated withMedical College of WisconsinMD Anderson Cancer Center
    • , R. GarciaAffiliated withMedical College of WisconsinHospital Regional De Alta Especialidad De Oaxaca
    • , M. GoodmanAffiliated withMedical College of WisconsinTuff’s Medical Center
    • , N. HannaAffiliated withUniversity of Maryland Medical Center
    • , L. HarrisonAffiliated withWake Forest University Baptist Medical CenterNew Jersey Medical School
    • , R. HoeferAffiliated withWake Forest University Baptist Medical CenterSentara Surgical Associates
    • , M. HoltzmanAffiliated withMedical College of WisconsinUniversity of Pittsburgh
    • , J. KaneAffiliated withWake Forest University Baptist Medical CenterRoswell Park Cancer Center
    • , D. LabowAffiliated withWake Forest University Baptist Medical CenterMount Sinai Medical Center
    • , B. LiAffiliated withMedical College of WisconsinLouisiana State University Health Sciences Center
    • , A. LowyAffiliated withWake Forest University Baptist Medical CenterSan Diego Medical Center, University of California
    • , P. MansfieldAffiliated withMedical College of WisconsinMD Anderson Cancer Center
    • , E. OngAffiliated withWake Forest University Baptist Medical CenterUniversity of Arizona
    • , C. PameijerAffiliated withWake Forest University Baptist Medical CenterStony Brook University Medical Center
    • , J. PingpankAffiliated withWake Forest University Baptist Medical CenterUPMC Cancer Pavilion
    • , M. QuinonesAffiliated withWake Forest University Baptist Medical CenterDekalb Medical Center
    • , R. RoyalAffiliated withMedical College of WisconsinMD Anderson Cancer Center
    • , G. SaltiAffiliated withWake Forest University Baptist Medical CenterUniversity of Illinois Masonic Medical Center
    • , A. SardiAffiliated withSharp Health CareMercy Medical Center
    • , P. ShenAffiliated withWake Forest University Baptist Medical Center
    • , J. SkitzkiAffiliated withWake Forest University Baptist Medical CenterRoswell Park Cancer Center
    • , J. SpellmanAffiliated withSharp Health CareBeebe Medical Center
    • , J. StewartAffiliated withWake Forest University Baptist Medical Center
    • , J. EsquivelAffiliated withSharp Health CareSt. Agnes Hospital Email author 

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Abstract

Background

The American Society of Peritoneal Surface Malignancies (ASPSM) is a consortium of cancer centers performing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). This is a position paper from the ASPSM on the standardization of the delivery of HIPEC.

Methods

A survey was conducted of all cancer centers performing HIPEC in the United States. We attempted to obtain consensus by the modified method of Delphi on seven key HIPEC parameters: (1) method, (2) inflow temperature, (3) perfusate volume, (4) drug, (5) dosage, (6) timing of drug delivery, and (7) total perfusion time. Statistical analysis was performed using nonparametric tests.

Results

Response rates for ASPSM members (n = 45) and non-ASPSM members (n = 24) were 89 and 33 %, respectively. Of the responders from ASPSM members, 95 % agreed with implementing the proposal. Majority of the surgical oncologists favored the closed method of delivery with a standardized dual dose of mitomycin for a 90-min chemoperfusion for patients undergoing cytoreductive surgery for peritoneal carcinomatosis of colorectal origin.

Conclusions

This recommendation on a standardized delivery of HIPEC in patients with colorectal cancer represents an important first step in enhancing research in this field. Studies directed at maximizing the efficacy of each of the seven key elements will need to follow.