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Laparoscopic cytoreductive surgery and HIPEC in LAMN with small volume of peritoneal disease: a valuable option of treatment for good patient-related experience measures (PREMs)

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Abstract

Background

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the best effective treatment for pseudomyxoma peritonei (PMP). In the last years, the advances in histopathology have stratified PMP lesions in different degrees of aggressivity suggesting the possibility of a tailored treatment. In a subset of patients with small volume peritoneal disease, laparoscopic CRS and HIPEC is feasible. The aim of this study is to analyze the results of laparoscopic CRS + HIPEC in a monocentric series of patients under patient-related experience measures (PREMs).

Methods

All consecutive patients who underwent laparoscopic CRS-HIPEC with curative intent at Cancer Institute of Montpellier were retrieved from a prospectively maintained database and analyzed. Selection criteria for laparoscopic approach were low-grade PMP with pathological confirmation prior to CRS-HIPEC, age < 75 years, no extra-peritoneal disease, peritoneal cancer index (PCI) < 10, and a limited history of abdominal surgery. A PREMS interview was conducted before analysis with all the included patients. Outcomes of interest included postoperative morbidity, medium-term survival, and PREMs.

Results

Fourteen patients were operated on for low-grade PMP with a laparoscopic approach at our institution. Conversions to laparotomy were necessary in three patients, and postoperative complications were observed in three patients (Clavien 3b in one patient). In-hospital postoperative median stay was 9.5 days. No death or recurrence was observed during the study period.

Conclusions

Laparoscopic CRS-HIPEC for LAMN in presence of small peritoneal disease is feasible in terms of postoperative morbidity and mortality. According to our PREMs questionnaire, patients' expectations were satisfied.

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Abbreviations

CRS:

Cytoreductive surgery

HIPEC:

Hyperthermic intraperitoneal chemotherapy

LAMN:

Low-grade appendiceal mucinous neoplasm

PM:

Peritoneal metastases

PSM:

Peritoneal surface malignancy

PREMs:

Patient-related experience measures

PROMs:

Patient-related outcomes measures

PRGS:

Peritoneal regression grading score

References

  1. Sugarbaker PH (1998) Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol 14(3):254–261. https://doi.org/10.1002/(SICI)1098-2388(199804/05)14:3%3c254::AID-SSU10%3e3.0.CO;2-U

    Article  CAS  PubMed  Google Scholar 

  2. Benhaim L, Faron M, Gelli M, Sourrouille I, Honoré C, Delhorme J-B, Elias D, Goere D (2019) Survival after complete cytoreductive surgery and HIPEC for extensive pseudomyxoma peritonei. Surg Oncol 29:78–83. https://doi.org/10.1016/j.suronc.2019.03.004

    Article  PubMed  Google Scholar 

  3. Rodríguez-Ortiz L, Arjona-Sánchez A, Ibañez-Rubio M, Sánchez-Hidalgo J, Casado-Adam A, Rufián-Peña S, Briceño-Delgado J (2020) Laparoscopic cytoreductive surgery and HIPEC: a comparative matched analysis. Surg Endosc. https://doi.org/10.1007/s00464-020-07572-x

    Article  PubMed  Google Scholar 

  4. Dumont F, Duchalais E, Aumont A, Thibaudeau E (2020) Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy by laparoscopy via a single-port approach for low-grade peritoneal malignancy. Surg Endosc 34(6):2789–2795. https://doi.org/10.1007/s00464-020-07492-w

    Article  CAS  PubMed  Google Scholar 

  5. Abudeeb H, Selvasekar CR, O’Dwyer ST, Chakrabarty B, Malcolmson L, Renehan AG, Wilson MS, Aziz O (2020) Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms. Surg Endosc 34(12):5516–5521. https://doi.org/10.1007/s00464-019-07349-x

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mercier F, Jeremie G, Alyami M, Delphine V, Vahan K, Pascal R, Sylvie I, Guillaume P, Olivier G (2020) Long-term results of laparoscopic cytoreductive surgery and HIPEC for the curative treatment of low-grade pseudomyxoma peritonei and multicystic mesothelioma. Surg Endosc 34(11):4916–4923. https://doi.org/10.1007/s00464-019-07280-1

    Article  PubMed  Google Scholar 

  7. Sgarbura O, Al Hosni M, Petruzziello A, Figueroa R, Khellaf L, Pissas MH, Carrère S, Nougaret S, Bibeau F, Quénet F (2020) Complete pathologic response after two-stage cytoreductive surgery with HIPEC for bulky pseudomyxoma peritonei: proof of concept. Int J Hyperth 37(1):585–591. https://doi.org/10.1080/02656736.2020.1772511

    Article  CAS  Google Scholar 

  8. Kusamura S, Kepenekian V, Villeneuve L, Lurvink RJ, Govaerts K, Hingh IHJTD, Moran BJ, der Speeten KV, Deraco M, Glehen O, Barrios-Sanchez P, Baumgartner JM, Ben-Yaacov A, Bertulli R, Cashin P, Cecil T, Dayal S, Simone MD, Foster JM, Yu Y (2020) Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Eur J Surg Oncol. https://doi.org/10.1016/j.ejso.2020.02.011

    Article  PubMed  Google Scholar 

  9. Passot G, Bakrin N, Roux AS, Vaudoyer D, Gilly F-N, Glehen O, Cotte E (2014) Quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: a prospective study of 216 patients. Eur J Surg Oncol 40(5):529–535. https://doi.org/10.1016/j.ejso.2013.11.019

    Article  CAS  PubMed  Google Scholar 

  10. Rudolph C, Petersen GS, Pritzkuleit R, Storm H, Katalinic A (2019) The acceptance and applicability of a patient-reported experience measurement tool in oncological care: a descriptive feasibility study in northern Germany. BMC Health Serv Res 19(1):786. https://doi.org/10.1186/s12913-019-4646-4

    Article  PubMed  PubMed Central  Google Scholar 

  11. Villeneuve L, Passot G, Glehen O, Isaac S, Bibeau F, Rousset P, Gilly FN, Network RENAPE (2017) The RENAPE observational registry: rationale and framework of the rare peritoneal tumors French patient registry. Orphanet J Rare Dis 12(1):37. https://doi.org/10.1186/s13023-017-0571-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Sugarbaker PH (2005) Cytoreductive surgery and perioperative intraperitoneal chemotherapy: a new standard of care for appendiceal mucinous tumors with peritoneal dissemination. Clin Colon Rectal Surg 18(03):204–214. https://doi.org/10.1055/s-2005-916281

    Article  PubMed  PubMed Central  Google Scholar 

  13. Taibi A, Geyl S, Salle H, Salle L, Mathonnet M, Usseglio J, Durand Fontanier S (2020) Systematic review of patient reported outcomes (PROs) and quality of life measures after pressurized intraperitoneal aerosol chemotherapy (PIPAC). Surg Oncol 35:97–105. https://doi.org/10.1016/j.suronc.2020.08.012

    Article  PubMed  Google Scholar 

  14. Govaerts K, Lurvink RJ, De Hingh IHJT, Van der Speeten K, Villeneuve L, Kusamura S, Kepenekian V, Deraco M, Glehen O, Moran BJ, PSIGI (2020) Appendiceal tumours and pseudomyxoma peritonei: literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment. Eur J Surg Oncol. https://doi.org/10.1016/j.ejso.2020.02.012

    Article  PubMed  Google Scholar 

  15. McDonald JR, O’Dwyer ST, Rout S, Chakrabarty B, Sikand K, Fulford PE, Wilson MS, Renehan AG (2012) Classification of and cytoreductive surgery for low-grade appendiceal mucinous neoplasms. Br J Surg 99(7):987–992. https://doi.org/10.1002/bjs.8739

    Article  CAS  PubMed  Google Scholar 

  16. Guaglio M, Sinukumar S, Kusamura S, Milione M, Pietrantonio F, Battaglia L, Guadagni S, Baratti D, Deraco M (2018) Clinical surveillance after macroscopically complete surgery for low-grade appendiceal mucinous neoplasms (LAMN) with or without limited peritoneal spread: long-term results in a prospective series. Ann Surg Oncol 25(4):878–884. https://doi.org/10.1245/s10434-017-6305-5

    Article  PubMed  Google Scholar 

  17. Foster JM, Sleightholm RL, Wahlmeier S, Loggie B, Sharma P, Patel A (2016) Early identification of DPAM in at-risk low-grade appendiceal mucinous neoplasm patients: a new approach to surveillance for peritoneal metastasis. World J Surg Oncol 14(1):243. https://doi.org/10.1186/s12957-016-0996-0

    Article  PubMed  PubMed Central  Google Scholar 

  18. Honoré C, Caruso F, Dartigues P, Benhaim L, Chirica M, Goéré D, Elias D (2015) Strategies for preventing pseudomyxoma peritonei after resection of a mucinous neoplasm of the appendix. Anticancer Res 35(9):4943–4947

    PubMed  Google Scholar 

  19. Fournier K, Rafeeq S, Taggart M, Kanaby P, Ning J, Chen H-C, Overman M, Raghav K, Eng C, Mansfield P, Royal R (2017) Low-grade appendiceal mucinous neoplasm of uncertain malignant potential (LAMN-UMP): prognostic factors and implications for treatment and follow-up. Ann Surg Oncol 24(1):187–193. https://doi.org/10.1245/s10434-016-5588-2

    Article  PubMed  Google Scholar 

  20. Esquivel J, Averbach A (2012) Laparoscopic cytoreductive surgery and HIPEC in patients with limited pseudomyxoma peritonei of appendiceal origin [clinical study]. Gastroenterol Res Pract. https://doi.org/10.1155/2012/981245

    Article  PubMed  PubMed Central  Google Scholar 

  21. Arjona-Sanchez A, Esquivel J, Glehen O, Passot G, Turaga KK, Labow D, Rufian-Peña S, Morales R, van der Speeten K (2019) A minimally invasive approach for peritonectomy procedures and hyperthermic intraperitoneal chemotherapy (HIPEC) in limited peritoneal carcinomatosis: The American Society of Peritoneal Surface Malignancies (ASPSM) multi-institution analysis. Surg Endosc 33(3):854–860. https://doi.org/10.1007/s00464-018-6352-4

    Article  CAS  PubMed  Google Scholar 

  22. Arjona-Sánchez A, Cortés-Guiral D, Duran-Martínez M, Villarejo-Campos P, Sánchez-Hidalgo JM, Casado-Adam A, Rodriguez-Ortiz L, Romero-Ruiz A, Rufian-Andujar B, Espinosa-Redondo E, Valenzuela-Molina F, Rufián-Peña S, Briceño-Delgado J (2020) Complete laparoscopic pelvic peritonectomy plus hyperthermic intraperitoneal chemotherapy. Tech Coloproctol 24(10):1083–1088. https://doi.org/10.1007/s10151-020-02277-8

    Article  PubMed  Google Scholar 

  23. Kusamura S, Moran BJ, Sugarbaker PH, Levine EA, Elias D, Baratti D, Morris DL, Sardi A, Glehen O, Deraco M, Peritoneal Surface Oncology Group International (PSOGI) (2014) Multicentre study of the learning curve and surgical performance of cytoreductive surgery with intraperitoneal chemotherapy for pseudomyxoma peritonei. Br J Surg 101(13):1758–1765. https://doi.org/10.1002/bjs.9674

    Article  CAS  PubMed  Google Scholar 

  24. Noiret B, Clement G, Lenne X, Bruandet A, Glehen O, Voron T, Piessen G, Eveno C (2020) Centralization and oncologic training reduce postoperative morbidity and failure-to-rescue rates after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies: study on a 10-year national french practice. Ann Surg 272(5):847–854. https://doi.org/10.1097/SLA.0000000000004326

    Article  PubMed  Google Scholar 

  25. Arjona-Sanchez A, Aziz O, Passot G, Salti G, Esquivel J, Van der Speeten K, Piso P, Nedeclut S, Sommariva A, Yonemura Y, Turaga K, Selvasekar CR, Rodriguez-Ortiz L, Sanchez-Hidalgo JM, Casado-Adam A, Rufian-Peña S, Briceño J, Glehen O (2020) Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for limited peritoneal metastasis The PSOGI international collaborative registry. Eur J Surg Oncol. https://doi.org/10.1016/j.ejso.2020.11.140

    Article  PubMed  Google Scholar 

  26. Passot G, Dumont F, Goéré D, Arvieux C, Rousset P, Regimbeau J-M, Elias D, Villeneuve L, Glehen O, BIG-RENAPE Surgery Working Group (2018) Multicentre study of laparoscopic or open assessment of the peritoneal cancer index (BIG-RENAPE). The Br J Surg 105(6):663–667. https://doi.org/10.1002/bjs.10723

    Article  CAS  PubMed  Google Scholar 

  27. Chua TC, Moran BJ, Sugarbaker PH, Levine EA, Glehen O, Gilly FN, Baratti D, Deraco M, Elias D, Sardi A, Liauw W, Yan TD, Barrios P, Gómez Portilla A, de Hingh IHJT, Ceelen WP, Pelz JO, Piso P, González-Moreno S, Morris DL (2012) Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. J Clin Oncol 30(20):2449–2456. https://doi.org/10.1200/JCO.2011.39.7166

    Article  PubMed  Google Scholar 

  28. Leimkühler M, Hentzen JEKR, Hemmer PHJ, Been LB, van Ginkel RJ, Kruijff S, van Leeuwen BL, de Bock GH (2020) Systematic review of factors affecting quality of life after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol 27(10):3973–3983. https://doi.org/10.1245/s10434-020-08379-9

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hübner M, Kusamura S, Villeneuve L, Al-Niaimi A, Alyami M, Balonov K, Bell J, Bristow R, Guiral DC, Fagotti A, Falcão LFR, Glehen O, Lambert L, Mack L, Muenster T, Piso P, Pocard M, Rau B, Sgarbura O, Somashekhar SP, Wadhwa A, Altman A, Fawcett W, Veerapong J, Nelson G (2020) Guidelines for perioperative care in cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC): enhanced recovery after surgery (ERAS®) society recommendations—part I: preoperative and intraoperative management. Eur J Surg Oncol 46(12):2292–2310. https://doi.org/10.1016/j.ejso.2020.07.041

    Article  PubMed  Google Scholar 

  30. Hübner M, Kusamura S, Villeneuve L, Al-Niaimi A, Alyami M, Balonov K, Bell J, Bristow R, Guiral DC, Fagotti A, Falcão LFR, Glehen O, Lambert L, Mack L, Muenster T, Piso P, Pocard M, Rau B, Sgarbura O, Somashekhar SP, Wadhwa A, Altman A, Fawcett W, Veerapong J, Nelson G (2020) Guidelines for perioperative care in cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC): enhanced recovery after surgery (ERAS®) society recommendations—part II: postoperative management and special considerations. Eur J Surg Oncol 46(12):2311–2323. https://doi.org/10.1016/j.ejso.2020.08.006

    Article  PubMed  Google Scholar 

  31. Sheehan LA, Mehta AM, Sawan S, Dayal SP, Mohamed F, Moran BJ, Cecil TD (2017) Preserving fertility in pseudomyxoma peritonei, a novel approach. Pleura Peritoneum 2(1):33–36. https://doi.org/10.1515/pp-2016-0024

    Article  PubMed  PubMed Central  Google Scholar 

  32. Ortega-Deballon P, Glehen O, Levine E, Piso P, Sugarbaker PH, Hayes-Jordan A, Facy A, Bakrin N, Rat P (2011) Childbearing after hyperthermic intraperitoneal chemotherapy: results from an international survey. Ann Surg Oncol 18(8):2297–2301. https://doi.org/10.1245/s10434-011-1595-5

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kepenekian V, Péron J, Goéré D, Sgarbura O, Delhorme JB, Eveno C, Benzerdjeb N, Bonnefoy I, Villeneuve L, Rousset P, Abboud K, Pocard M, Glehen O (2021) Multicystic peritoneal mesothelioma treated with cytoreductive surgery followed or not by hyperthermic intraperitoneal chemotherapy: results from a large multicentric cohort. Int J Hyperthermia 38(1):805–814. https://doi.org/10.1080/02656736.2021.1903585

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

SIRIC Montpellier Cancer Grant INCa Inserm DGOS 12553.

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Authors and Affiliations

  1. Hepato–Pancreato–Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de HautepierreHôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France

    Caterina Cusumano

  2. Department of Surgical Oncology, Cancer Institute Montpellier, University of Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France

    Sébastien Carrere, Alix Bouillin, François Quénet & Olivia Sgarbura

  3. Department of Radiology, Cancer Institute Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France

    Stéphanie Nougaret

  4. Department of Pathology, Cancer Institute Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 05, France

    Lakhdar Khellaf

  5. IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Institut Régional du Cancer de Montpellier, Université de Montpellier, 34298, Montpellier, France

    Olivia Sgarbura

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  1. Caterina Cusumano
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Correspondence to Olivia Sgarbura.

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Dr. François Quénet is a consultant for Gamida. Drs Caterina Cusumano, Sébastien Carrere, Alix Bouillin, Lakhdar Khellaf, Stéphanie Nougaret, and Olivia Sgarbura have no conflicts of interest or financial ties to disclose.

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Cusumano, C., Carrere, S., Bouillin, A. et al. Laparoscopic cytoreductive surgery and HIPEC in LAMN with small volume of peritoneal disease: a valuable option of treatment for good patient-related experience measures (PREMs). Surg Endosc 36, 4757–4763 (2022). https://doi.org/10.1007/s00464-021-08816-0

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