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The 2022 PSOGI International Consensus on HIPEC Regimens for Peritoneal Malignancies: Methodology

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

A group of experts from the Peritoneal Surface Oncology Group International (PSOGI) and the BIG-RENAPE group carried out a consensus among surgeons experienced in treating peritoneal malignancies from around the world to derive recommendations on indications of hyperthermic intraperitoneal chemotherapy (HIPEC), choice and details of HIPEC regimens, and areas for future research. This manuscript describes the methodology of achieving this consensus and the degree of participation of experts.

Methods

The Delphi technique was used and the questionnaire comprised three categories: evidence-based recommendations using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system with the PICO (patient, intervention, comparison, and outcome) method, an opinion survey, and research recommendations. A consensus was achieved if any one option had >50% of votes, or positive or negative recommendations combined had > 70% of votes.

Results

Of the 145 experts solicited, 71.1% in round I and 72.2% in round II took the survey. Participation was highest among surgeons treating both gastrointestinal and gynecological malignancies. Of 113 questions, after round I, a consensus was achieved for 72 (63.7%) questions, and after the second round, consensus was achieved for another 22 (19.4%) questions, making a total of 94 (83.1%) questions for which a consensus was achieved.

Conclusion

This consensus was carried out using a thorough review of literature and robust rating of evidence, and included key experts and opinion leaders from across the world. The results could guide clinicians on the use of HIPEC, both in their day-to-day clinical practice and in designing clinical trials.

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Acknowledgment

The authors thank the members of each Working Group for lending their expertise, time, and effort to this project. Members of the different working groups: Technical considerations: Kurt Van der Speeten (Belgium), Pompiliu Piso (Germany), Victor Verwaal (Sweden), Shigeki Kusamura (Italy) and Olivier Glehen (France). Colorectal cancer: Martin Hubner (Switzerland), Ignace de Hingh (The Netherlands), Kim Govaerts (Belgium), Shigeki Kusamura (Italy) and Kurt Van der Speeten (Belgium). Gastric cancer: Olivier Glehen (France), Clarisse Eveno (France), Mohammad Alyami (Saudi Arabia), Beate Rau (Germany) and Santiago Gonzalez-Moreno (Spain). Epithelial ovarian cancer: Naoual Bakrin (France), Willemien van Driel (The Netherlands), Oliver Zivanovic (USA), Cedric Nadeau (France) and Aditi Bhatt (India). Pseudomyxoma peritonei: Shigeki Kusamura (Italy), Brendan Moran (UK), Jean-Baptiste Delhorme (France), Abdelkader Taibi (France) and Marcello Deraco (Italy). Peritoneal mesothelioma: Marcello Deraco (Italy), Vahan Kepenekian (France), Olivia Sgarbura (France), Shigeki Kusamura (Italy) and Frederic Marchal (France).

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Author notes

  1. Shigeki Kusamura and Aditi Bhatt are joint first authors as they contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Shigeki Kusamura MD, PhD & Marcelo Deraco MD, PhD

  2. Department of Surgical Oncology, Zydus Hospital, Ahmedabad, India

    Aditi Bhatt MS, MCh

  3. Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland

    Martin Hubner MD, PhD

  4. Department of Clinical Research, Centre Hospitalier Lyon-sud, Lyon, France

    Laurent Villeneuve MBE, PhD

  5. Department of Surgical Oncology, Centre Hospitalier Lyon-sud, Lyon, France

    Naoual Bakrin MD, PhD & Olivier Glehen MD, PhD

  6. Department of Surgical Oncology, Zeikenhuis Oost-Limberg, Genk, Belgium

    Kurt Van Der Speeten MD, PhD

  7. Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France

    Olivier Glehen MD, PhD

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  1. Shigeki Kusamura MD, PhD
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Correspondence to Olivier Glehen MD, PhD.

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Disclosure

Olivier Glehen is a consultant for Gamida. Shigeki Kusamura, Aditi Bhatt, Martin Hubner, Laurent Villeneuve, Marcelo Deraco, Naoual Bakrin, and Kurt Van Der Speeten report no conflict of interests.

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Kusamura, S., Bhatt, A., Hubner, M. et al. The 2022 PSOGI International Consensus on HIPEC Regimens for Peritoneal Malignancies: Methodology. Ann Surg Oncol 30, 2508–2519 (2023). https://doi.org/10.1245/s10434-022-12990-3

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