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                                                                                                                                                                                Pseudomyxoma Peritonei Surgery and Treatment


                                                                                                                                                                                How to Select a PMP Surgeon, Part III

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                                                                                                                                                                                How to Select a Surgeon, Part III: Meet the “Charge Nurse”

                                                                                                                                                                                While most patients take the time to interview their surgeon prior to scheduling CRS and HIPEC, few take the time to tour the floor of the hospital where recuperation will take place following surgery.

                                                                                                                                                                                Typically, Pals spend 24 to 48 hours in ICU, immediately following surgery, before being released to the surgery recovery floor for the duration of their hospitalized recuperation.

                                                                                                                                                                                The “charge nurse” is responsible for supervising the floor/unit where you will recuperate. S/he assigns nurses to specific patients, and monitors the unit to be staffed adequately to meet the needs of the patients. Charge nurses may also provide direct patient care when needed and may serve as liaisons between patients and the nursing staff. Charge nurses may be rotated throughout the week, therefore, the charge nurse may change from day to day. In some hospitals, charge nurses maintain that position for longer periods of time.

                                                                                                                                                                                On the day you interview your surgeon, request to meet with the “charge nurse” of the floor where you will recuperate. Ask the charge nurse to give you a tour of the ward.  You and your family caregiver will want to see an example of the room where you will recuperate, as well as any amenities the floor or hospital may have to offer, e.g. a lounge for patients and caregivers, cafeteria, access to Wi-Fi, etc.

                                                                                                                                                                                Prior to meeting with the charge nurse, prepare your list of questions for him/her, just as you prepare your questions for the surgeon. Among the questions to consider asking are the following:

                                                                                                                                                                                What is the "nurse to patient" ratio on this floor? (How many patients are assigned to each nurse?)

                                                                                                                                                                                Will the majority of your hands on nursing care be provided by RNs, LVNs, or licensed aides?

                                                                                                                                                                                How many HIPEC patients are cared for on this floor each week? (How experienced is the nursing staff in taking care of HIPEC patients?)

                                                                                                                                                                                These are just a few of the important questions patients must consider when selecting a surgeon/specialist. It's important to pay attention to these details regarding the hospital itself because after you are released from the ICU, you will spend the remainder of your hospitalized recuperation on the floor (unit or ward) supervised by the charge nurse.

                                                                                                                                                                                As a proactive cancer patient and consumer, interview all potential healthcare providers whenever possible. Your health and your future are deserving of your time and attention to investigating your healthcare treatment plan thoroughly, prior to scheduling your surgery.

                                                                                                                                                                                These are just a few of the important considerations that one must examine prior to selecting a surgeon/specialist. A more detailed and comprehensive list of questions is included in the PMP Pals’ Network Handbook: Preparing for Surgery. This handbook is provided to all new members of the PMP Pals’ Network.

                                                                                                                                                                                  Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by the PMP Pals’ Network. All rights reserved.



                                                                                                                                                                                Question to Ask Before Scheduling PMP Surgery

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                                                                                                                                                                                Basic Questions to Ask Your Surgeon Prior to Surgery
                                                                                                                                                                                Source: Johns Hopkins Medicine

                                                                                                                                                                                Questions to Ask Your Surgeon for Pseudomyxoma Peritonei

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                                                                                                                                                                                The PMP Pals’ Network suggests that patients prepare a personal list of questions prior to meeting ith a surgeon for a pre op evaluation.

                                                                                                                                                                                Here are a few questions for your consideration. Refer to the PMP Pals’ Handbooks, Preparing for a Consultation with a Specialist and Preparing for Surgery for detailed lists of questions to ask your physician.


                                                                                                                                                                                Treatment

                                                                                                                                                                                Is my diagnosis aggressive? Does it require treatment?

                                                                                                                                                                                What are my treatment options for my particular diagnosis?

                                                                                                                                                                                If you were me, which option would you choose and why?

                                                                                                                                                                                What is my prognosis with the treatment you recommend?

                                                                                                                                                                                What is my prognosis without treatment?

                                                                                                                                                                                What does “watch and wait” mean?

                                                                                                                                                                                Surgery     

                                                                                                                                                                                Will any organs be removed?

                                                                                                                                                                                If so, what, if any, are the ramifications of losing those organs?

                                                                                                                                                                                Will I have an ostomy? If so, which type? Ileostomy? Colostomy? Urostomy?

                                                                                                                                                                                If I have an ostomy, can it be “reversed?” If so, when?

                                                                                                                                                                                Will I have the HIPEC treatment? Is HIPEC optional?

                                                                                                                                                                                How will my pain be controlled after surgery?

                                                                                                                                                                                What, if any, are the risks/complications from this surgery? From HIPEC?

                                                                                                                                                                                Will the HIPEC treatment and your fees as my attending surgeon covered by my insurance?

                                                                                                                                                                                Post Op (After Surgery)

                                                                                                                                                                                Will my family caregiver be able to visit me in the ICU?

                                                                                                                                                                                How often will you visit me during my hospitalization?

                                                                                                                                                                                Who will oversee my post op recuperation? You (my attending surgeon) or the Fellows or Residents?

                                                                                                                                                                                How long will I be hospitalized?

                                                                                                                                                                                When will I be able to return to work?

                                                                                                                                                                                When will I be able to return to work?

                                                                                                                                                                                Surgeon’s Experience

                                                                                                                                                                                How many patients with my diagnosis do you treat each year?

                                                                                                                                                                                How many surgeries have you performed on patients with conditions like mine?

                                                                                                                                                                                How often do you treat patients with the HIPEC procedure?

                                                                                                                                                                                How experienced is your surgical team and post op nursing staff in treating patients with my condition?

                                                                                                                                                                                Refer to the PMP Pals’ Handbooks, Preparing for a Consultation with a Specialist and Preparing for Surgery for detailed lists of questions to ask your physician.
                                                                                                                                                                                 


                                                                                                                                                                                Why Doesn't My Surgeon Specialist Visit Me Daily?


                                                                                                                                                                                Most PMP Pal members choose to schedule their surgeries at university hospitals. The majority of our surgeon specialists are professors; the young physicians who do visit you daily (more commonly twice a day) are their students, who carefully report on your daily condition, under the supervision of your surgeon specialist.

                                                                                                                                                                                Due to the detailed nature of our surgeries, it is not uncommon for our operations to last eight to fourteen hours, sometimes even longer. The time surgeons spend in the operating room does not include prep time to evaluate and plan the treatment of your individual case; this requires additional time.

                                                                                                                                                                                The long hours in the operating room, combined with hours devoted to consulting with newly diagnosed patients in the clinic, time devoted to research studies, time scheduled for coordination and preparation of symposiums and conferences, etc, leaves little time for daily bedside visits with patients in the hospital. Therefore, frequent monitoring of the patient’s recuperation, as conducted by the nursing staff and physicians in residence/training, provides the surgeon specialist with the opportunity to supervise your recuperation without daily visits.

                                                                                                                                                                                When your surgeon does visit you, don’t be surprised if s/he pops in very early in the morning (on the way to surgery) or very late at night (after surgery has been completed.)


                                                                                                                                                                                Copyright © 2012 by PMP Pals’ Network. All rights reserved.
                                                                                                                                                                                Articles published by the PMP Pals’ Network and posted on www.pmppals.org are not intended as a substitute for professional medical or legal care. Individuals should seek the counsel of licensed healthcare professionals regarding their own specific needs. Visit us on the web at www.pmppals.org 


                                                                                                                                                                                Today's Article of Interest

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                                                                                                                                                                                Doctors and Nurses in Training
                                                                                                                                                                                by Jim, Pal Mentor, and Gabriella, Patient

                                                                                                                                                                                Most Appendix Cancer/Pseudomyxoma Peritonei patients select to have their surgeries at teaching hospitals associated with universities. Unlike smaller community hospitals, patients at university teaching hospitals are often attended to by medical students, interns, residents, fellows, and nursing students who will take a special interest in your case and in your care. Throughout your hospitalization, your care will be supervised by your specialist surgeon (even if you don’t see him or her daily.) After surgery, the majority of our fellow PMP Pals do not see their surgeon specialist more than once or twice a week; nevertheless, your specialist will be monitoring your case closely.

                                                                                                                                                                                The physicians and nurses in training may ask you many questions and may examine you thoroughly during your recuperation. This level of care is seen as an advantage to many patients who would otherwise not receive such close attention at a community hospital.

                                                                                                                                                                                Keep in mind that Pseudomyxoma Peritonei is very rare and that any aspects of treatment that student physicians and nurses learn from talking with and treating you, will help their knowledge base to grow and thus will help our fellow patients in the future.


                                                                                                                                                                                Copyright © 2012 by PMP Pals’ Network. All rights reserved.

                                                                                                                                                                                Articles published by the PMP Pals’ Network and posted on www.pmppals.org are not intended as a substitute for professional medical or legal care. Individuals should seek the counsel of licensed healthcare professionals regarding their own specific needs. Visit us on the web at www.pmppals.org
                                                                                                                                                                                 



                                                                                                                                                                                How Long Does it Really Take to Recover from PMP Surgery?

                                                                                                                                                                                Fred Suggests a Frank Discussion About Post Op Recovery!

                                                                                                                                                                                By “Pal” member, Fred, from the USA

                                                                                                                                                                                “A frequent concern that arises among patients who are planning to, or have had CRS and HIPEC, is the length of time required to recover.  A corollary to recovery time is what “recovery” actually means.   Before addressing these issues, I should emphasize that each patient’s experience will differ depending on a host of factors (e.g., age, general health, extent of tumors, type of cancer, invasiveness of surgery, etc.).  There is no simple rule of thumb to determine an expected recovery time.

                                                                                                                                                                                What is recovery?  How do patients and surgeons define “recovery?”

                                                                                                                                                                                This question is one that never occurred to me in my initial discussions with my surgeon; as a result there was a misunderstanding.  He did not mince words regarding the seriousness of my condition and the necessary surgery.  However, he indicated that I should be back to “normal” in a few months.  The problem was his idea of “normal” and mine were different.  I viewed “normal” as my state of health prior to developing the disease.  His notion was apparently being able to return to work and everyday activities free of the disease. 

                                                                                                                                                                                In brief, my post operation weight dropped from about 150 to 109 before recovering to 118, which is my new “normal” (permanent weight loss is a common result of the surgery) and the necessary removal of various organs and sections of organs has had a major impact on my digestive system, which in turn has affected my quality of life in certain ways.  As I’ve often joked, I’ve developed a close personal relationship with my bathroom and have become much more aware of the locations of public facilities.  Thus, in one sense I’ve never “recovered” from the surgery; I have not returned to my prior state of health.

                                                                                                                                                                                However, I did return to work, returned to my nature photography, and took up competitive table tennis after a 30 year hiatus. I am physically able to do most things I did pre surgery, including working out at a fitness center several times a week, but am acutely aware of the limits due to the digestive issues.

                                                                                                                                                                                Time frame for recovery

                                                                                                                                                                                My particular surgery was about 10 hours. I spent almost a month in the hospital before being released, then another few days a week later due to dehydration. 

                                                                                                                                                                                At home, I began walking around the neighborhood gradually lengthening the time and distance as I felt stronger   I was able to return to my desk job on a part time basis 3 months after surgery and on a full time basis a couple of months later. 

                                                                                                                                                                                I began doing my nature photography carrying very limited equipment about 4 months after surgery and a full backpack about a year after surgery.

                                                                                                                                                                                Recovery, the “new normal”, and Senior Olympics!

                                                                                                                                                                                I retired 14 months after the surgery and began playing table tennis at a local club soon after, winning two bronze medals and a silver medal in the local senior Olympics and a bronze medal for my talent level at the 2011 U.S. nationals this past December. 

                                                                                                                                                                                Looking back, I’d say full recovery for me, which I’d define as reaching my new “normal,” took about 9-12 months.  As noted above, and as a former economist, I again emphasize that I represent just one data point.  Recovery time will vary considerably across individuals.”

                                                                                                                                                                                Articles posted in “PMP Pals” and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed professional legal or medical care. Each patient is unique and should seek the counsel of a licensed professional for their own specific case. Copyright © 2012 by PMP Pals’ Network/All rights reserved. Visit us on the web at www.pmppals.org

                                                                                                                                                                                Q & A for Pseudomyxoma Peritonei Surgery and Treatment

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                                                                                                                                                                                We're "veterans" of pseudomyxoma peritonei surgery and we'll support you!





                                                                                                                                                                                How is PMP treated?

                                                                                                                                                                                What are the treatment options for Pseudomyxoma Peritonei?

                                                                                                                                                                                Is surgery required for Pseudomyxoma Peritonei treatment?

                                                                                                                                                                                What treatment therapy is standard care for Pseudomyxoma Peritonei syndrome treatment?

                                                                                                                                                                                What are CRS surgery and HIPEC therapy?

                                                                                                                                                                                Are you or a loved one preparing for surgery for the treatment of Pseudomyxoma Peritonei syndrome?

                                                                                                                                                                                The PMP Pals' Network provides a wide variety of services to assist you in preparing for, and recuperating from, surgery as quickly as possible!

                                                                                                                                                                                Our  Preparing for Surgery Handbook and Newsletters provide step by step instructions to assist you with preparing for and recuperating from treatment.


                                                                                                                                                                                Our Pal Mentors will personally communicate with you via telephone, email, personal visits, SKYPE or web cam to help you, or your loved one prepare for surgery and/or HIPEC. We will share helpful resources and positive information to guide you through your recuperation!

                                                                                                                                                                                We are here to assist you in returning to your full and active life, as soon as possible!

                                                                                                                                                                                View photos and profiles of successful surgery survivors!

                                                                                                                                                                                Pseudomyxoma Peritonei Surgery, HIPEC and Chemotherapy overview


                                                                                                                                                                                Your surgical oncologist will explain and review all treatment options for Pseudomyxoma Peritonei. Your treatment plan will depend on your overall health, the type of tumor (pathology), the quantity (mass) size and location of the tumor, and whether the cancer has metastasized.

                                                                                                                                                                                Treatment for the Pseudomyxoma Peritonei syndrome generally includes CRS or cytoreductive surgery with or without systemic chemotherapy and HIPEC.

                                                                                                                                                                                The purpose of  debulking surgery is to remove as much tumor as possible. Debulking surgery often includes the removal of the omentum and the right colon. Additionally, for women, debulking will likely include a hysterectomy, if this was not perfomed previously. Adhesions become more troublesome with any additional debulking surgeries.

                                                                                                                                                                                Cytoreductive surgery is a detailed, lengthy procedure often requiring ten or more hours.
                                                                                                                                                                                Tumors are removed and destroyed using a variety of surgical techniques including argon beam coagulator, electro-evaporation, laser, and ultrasonic dissection.

                                                                                                                                                                                CRS (cytoreductive surgery)
                                                                                                                                                                                consists of the removal of as much mucin and visible tumor as possible, from the abdominal cavity. CRS surgery, refers to the removal of all visible tumors present throughout the peritoneal cavity. Cytoreductive Surgery includes thorough removal or destruction of all visible tumors throughout the surfaces of the peritoneum. Surgery may include the removal or resection of segments of small and large bowel, gall bladder, liver, omentum, ovaries, pancreas, spleen, stomach and uterus, and
                                                                                                                                                                                may require removing the lining of the peritoneum.

                                                                                                                                                                                The aim of cytoreductive surgery is to eliminate all tumor and metastatic tissues from the abdominal cavity, in order to effectively deliver intra-peritoneal heated chemotherapy (HIPEC).

                                                                                                                                                                                Cytoreductive Surgery or Cytoreduction (CRS) is performed under general anesthesia. CRS time averages eight to ten hours.

                                                                                                                                                                                A longitudinal incision is made in the abdomen. The abdomen, pelvis and organs therein are carefully inspected, during which time all operable visible and palpable tumors and tumor deposits are removed. The peritoneum is stripped.

                                                                                                                                                                                Following surgery patients are admitted to the intensive care unit (ICU) for 24 hours or longer, depending on the individual patient. Patients are then transferred to regular hospitalization for an average of two weeks. This time period will vary depending on the individual.

                                                                                                                                                                                Join the PMP Pals' Network and ask a Pal Mentor to assist you in preparing for surgery!

                                                                                                                                                                                Hemicolectomy is a surgical procedure involving the removal of a portion of the colon next to the appendix. This procedure may also include the removal of nearby blood vessels and lymph nodes at the same time.

                                                                                                                                                                                Peritonectomy refers to stripping the parietal peritoneum and resecting structures at the sites that contain adenomucinosis. A combination of surgical techniques are utilized including organ resection, when necessary and tumor destruction via electro-evaporation and argon beam coagulation.

                                                                                                                                                                                CRS surgery for Appendix Cancer and Pseudomyxoma Peritonei may include the following:

                                                                                                                                                                                Removal of the omentum, spleen and gall bladder,
                                                                                                                                                                                Right hemicolectomy, colectomy, removal of the rectum and sigmoid,
                                                                                                                                                                                Stripping tumor from the surface of the liver,
                                                                                                                                                                                Resection of the pancreas,
                                                                                                                                                                                Gastrectomy (partial or total removal of the stomach)
                                                                                                                                                                                Stripping the peritoneum from left and right hemidiaphragm;
                                                                                                                                                                                Pelvic peritonectomy,
                                                                                                                                                                                Ileostomy,
                                                                                                                                                                                colostomy or urostomy


                                                                                                                                                                                HIPEC may be included at the conclusion of the cytoreductive surgery for the treatment of pseudomyxoma peritonei and appendix cancer if substantial tumor debulking is accomplished through CRS. HIPEC may be administered when complete removal of visible tumor (or debulking) is achieved through cytoreductive surgery; it involves perfusion of the peritoneal cavity with chemotherapy heated to approximately 40 degrees Celsius.

                                                                                                                                                                                HIPEC is administered with the infusion of heated chemotherapy during the last 90 minutes of the CRS procedure. Through HIPEC the surgeon(s) intend to destroy any residual tumor cells that may not have been surgically removed during the actual CRS surgery process.

                                                                                                                                                                                Although this procedure may initially sound drastic to the newly diagnosed patient, rarely is resection and/or removal of all of these organs is required.


                                                                                                                                                                                Each patient's case is unique and most patients live productive and healthy lives following surgery!

                                                                                                                                                                                Learn about HIPEC

                                                                                                                                                                                Q&A: How are patients selected for surgery?

                                                                                                                                                                                This question is frequently asked by newly diagnosed patients and “veteran” patients experiencing a “recurrence of disease.”

                                                                                                                                                                                Why are some patients accepted for CRS or CRS/HIPEC while others are not?

                                                                                                                                                                                Is there any truth to the rumors that surgeons “cherry pick” their patients?

                                                                                                                                                                                Why isn’t every patient a candidate for surgery?

                                                                                                                                                                                Surgeons refer to the process of evaluating a surgical candidate as “patient selection.”

                                                                                                                                                                                Many factors are taken into consideration for patient selection.

                                                                                                                                                                                The success of CRS and HIPEC may be dependent on the:

                                                                                                                                                                                patient’s overall general health,

                                                                                                                                                                                complete removal of all tumor tissue,

                                                                                                                                                                                location of tumor site(s) and

                                                                                                                                                                                type of tumor (histology and differentiation.)

                                                                                                                                                                                The following is a very general explanation of how patients are selected as surgical candidates:

                                                                                                                                                                                1. Preliminary disease criteria

                                                                                                                                                                                Patients with metastasis to the peritoneum, aka Peritoneal Carcinomatosis.

                                                                                                                                                                                Patients with disease contained within the abdomen (without metastasis outside the abdomen)

                                                                                                                                                                                2. Preliminary general health criteria for patient selection

                                                                                                                                                                                Good overall heath lacking any major co-morbid conditions*.

                                                                                                                                                                                Age (some surgeons limit the ages of patients they will accept into surgery)

                                                                                                                                                                                Mental health (coherence, ability to understand instructions, evidence of chemical dependencies, etc.)

                                                                                                                                                                                Ability to pay for surgery (adequate health insurance coverage or ability to pay out-of-pocket for medical care)

                                                                                                                                                                                3. Preliminary review of patient medical history

                                                                                                                                                                                Medical history including surgical history, if applicable, co-morbid conditions* (ie diabetes, lung or heart disease) current medications (prescribed and OTC) allergies and family history

                                                                                                                                                                                History of present illness including summary of symptoms

                                                                                                                                                                                Operative reports of previous surgeries

                                                                                                                                                                                Pathology reports

                                                                                                                                                                                Record of previous chemotherapy and radiotherapy treatments, if applicable, including dates and protocols

                                                                                                                                                                                4. Extent of disease

                                                                                                                                                                                Evaluation of CT scans to determine PCI (Peritoneal Cancer Index.)

                                                                                                                                                                                The PCI helps the surgeon to determine the extent, volume and locations of the disease.

                                                                                                                                                                                Evaluation of tumor block samples from original surgery(ies) if applicable.

                                                                                                                                                                                Laparoscopy optional

                                                                                                                                                                                Biopsy optional

                                                                                                                                                                                Evaluation of tumor markers and associated lab tests

                                                                                                                                                                                Physical examination of the patient

                                                                                                                                                                                Learn how to prepare for surgery
                                                                                                                                                                                Order the PMP Pals' Network Handbook: Preparing for Surgery.*

                                                                                                                                                                                Slideshow "Getting Ready for Surgery" provides generic surgery information
                                                                                                                                                                                Presented by WB MD, August 2010


                                                                                                                                                                                Ostomies

                                                                                                                                                                                Request a Pal Mentor to help you prepare for and recuperate from surgery!


                                                                                                                                                                                Our Pal Mentors are "veterans" of surgery with Drs. Ahrendt, Bartlett, Esquivel, Goodman, Holtzman,Levine, Loggie, Lowy, Mansfield, Moran, Morris, Pingpank, Temple, Sardi, Shen, Stewart, Sugarbaker, Selby and Zeh!


                                                                                                                                                                                Learn more about systemic Chemotherapy

                                                                                                                                                                                CRS (Cytoreductive Surgery) in conjunction with HIPEC: Articles and Abstracts

                                                                                                                                                                                This week's featured articles:


                                                                                                                                                                                Upfront Compared to Delayed Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei Is Associated With Considerably Lower Perioperative Morbidity and Recurrence Rate.
                                                                                                                                                                                Chua TC, Liauw W, Zhao J, Morris DL.

                                                                                                                                                                                *UNSW Department of Surgery, St George Hospital, Kogarah, Sydney, Australia. †Department of Medical Oncology, Cancer Care Centre, St George Hospital, Kogarah, Sydney, Australia.

                                                                                                                                                                                Abstract

                                                                                                                                                                                BACKGROUND: Cytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) is a recognized management strategy for pseudomyxoma peritonei. We seek to evaluate the outcomes of patients treated upfront with CRS PIC compared to patients undergoing delayed CRS PIC as salvage or treatment for recurrences after initial debulking surgery.

                                                                                                                                                                                METHODS: Retrospective analysis of patients with low-grade pseudomyxoma peritonei treated within our institution were stratified according to upfront versus delayed CRS PIC after intial debulking surgery. Survival was analyzed using the Kaplan-Meier method and compared using the log-rank test.

                                                                                                                                                                                RESULTS: Of 83 patients treated, 35 patients (42%) underwent upfront and 48 patients (58%) underwent delayed CRS PIC. The peritoneal cancer index (P = 0.048), amount of blood transfusion intraoperatively (P = 0.003) and duration of operation (P = 0.007) was lesser in the upfront compared to delayed group. Upfront treatment confers 5-year recurrence-free survival benefit (77% vs 37%; P = 0.011) and 10-year overall survival benefit (67% vs 35%; P = 0.054) over delayed treatment.

                                                                                                                                                                                CONCLUSION: Upfront CRS PIC seems to confer beneficial perioperative outcomes and lower recurrence rates over delayed CRS PIC. Early referral to centralized treatment centers would seem to be a reasonable strategy to improve outcomes.

                                                                                                                                                                                Source: Annals of Surgical Oncology, Jan 13, 2011

                                                                                                                                                                                Laparoscopic Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Patients with Limited Peritoneal Surface Malignancies: Feasibility, Morbidity and Outcome in an Early Experience.

                                                                                                                                                                                Laparoscopic CRS and HIPEC in Patients with Limited PSMs

                                                                                                                                                                                Source: Esquivel J, Averbach A, Chua TC  St. Agnes Hospital, Baltimore, Maryland.

                                                                                                                                                                                Ann Surg. 2011 Jan 6. [Epub ahead of print]

                                                                                                                                                                                Abstract

                                                                                                                                                                                INTRODUCTION: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are being widely used in the treatment of patients with peritoneal surface malignancies. The open procedure has been associated with high grade III and IV morbidity and prolonged hospitalization.

                                                                                                                                                                                METHODS: Patients with peritoneal surface malignancies and no gross evidence of carcinomatosis on the computed tomographic scan were enrolled to undergo laparoscopic CRS and HIPEC. We aimed to assess the feasibility, safety, and outcome of this procedure. Postoperative complications were reported according to the National Cancer Institute Common Toxicity Criteria.

                                                                                                                                                                                RESULTS: From October 2008 to January 2010, 14 patients were enrolled into the protocol. Amongst these 14 patients, one patient was found with extensive carcinomatosis at the time of laparoscopy and had no surgical procedure. Thirteen patients had a complete cytoreduction and HIPEC, 10 (77%) laparoscopically and 3 (23%) were converted to an open procedure. There was one grade 3 morbidity (10%) and one patient (10%) in the laparoscopy group experienced a grade 4 complication, needing a reoperation for an internal hernia. Mean length of hospital stay was 6 days for those completed laparoscopically, 8 days for those converted to an open procedure and 8 days for a matched cohort of patients with an upfront open procedure.

                                                                                                                                                                                CONCLUSIONS: This initial investigative stage demonstrates the feasibility and safety of cytoreductive surgery and HIPEC via the laparoscopic route in selected patients with low-tumor volume and no small bowel involvement mainly from appendiceal malignancies. Longer follow-up and additional studies are required to evaluate its long-term efficacy.

                                                                                                                                                                                PMID: 21217512 [PubMed - as supplied by publisher] January 2011


                                                                                                                                                                                Study of 300+ Patients Treated with CRS and PIC


                                                                                                                                                                                Abstract of a study of 300+ Pseudomyxoma Peritonei patients treated with cytoreductive surgery and intraperitoneal chemotherapy. Describes "gold standard " of treatment.
                                                                                                                                                                                Source: Elias D, Gilly F, Quenet F, Bereder JM, Sidéris L, Mansvelt B, Lorimier G, Glehen O; the Association Française de Chirurgie.
                                                                                                                                                                                Department of Oncologic Surgery, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif Cédex, France March 2010

                                                                                                                                                                                Radiofrequency Ablation for Treatment of Unresectable Colorectal Pulmonary Metastes


                                                                                                                                                                                Radiofrequency ablation as an adjunct to systemic chemotherapy for colorectal pulmonary metastases. Radiofrequency ablation for colorectal pulmonary metastases represents a step forward towards a nonsurgical option of combining systemic and local treatment for metastatic disease and is a safe treatment with a low risk profile.

                                                                                                                                                                                Terence C. Chua, BScMed (Hons), MBBS 1, Kelly Thornbury, BMed 1, Akshat Saxena, BMedSc 1, Winston Liauw, MBBS, M Med Sci 2, Derek Glenn, MBBS 3, Jing Zhao, MD 1, David L. Morris, MD, PhD 1 *
                                                                                                                                                                                1Department of Surgery, University of New South Wales, St George Hospital, Sydney, Australia
                                                                                                                                                                                2Cancer Care Center, St George Hospital, Sydney, Australia
                                                                                                                                                                                3Department of Radiology, St George Hospital, Sydney, Australia
                                                                                                                                                                                Source: AMC Feb 2010 

                                                                                                                                                                                Treatment of Peritoneal Malignancies, including Pseudomyxoma Peritonei with CRS and HIPEC

                                                                                                                                                                                CONCLUSION: It is important to recognize the role of and indications for CRS and HIPEC. Biologic factors of the disease and completeness of resection are important prognostic factors. Cytoreductive surgery, combined with intraperitoneal chemotherapy, can improve survival in selected patients with peritoneal-based malignancies.

                                                                                                                                                                                Source:Department of Surgical Oncology, National Cancer Centre of Singapore, Singapore 2010

                                                                                                                                                                                Study of 523 Colorectal Peritoneal Carcinomatosis Cases: CRS and IPC
                                                                                                                                                                                Source: Journal of Clinical Oncology,2010

                                                                                                                                                                                12 Year Study of CRS and HIPEC for Pseudomyxoma Peritonei Treatment
                                                                                                                                                                                Source: In Vivo, 2009


                                                                                                                                                                                Morbidity and Mortality: Study of HIPEC and CRS for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgery, Feb 2009, Dr David Morris, Dr Tristan Yan



                                                                                                                                                                                CRS with HIPEC have improved quality and quantity of life for patients
                                                                                                                                                                                Source:Dr Brian Loggie, 2007

                                                                                                                                                                                HIPEC: Complexity
                                                                                                                                                                                Source: Dr David L Bartlett,Journal of Surgical Oncology

                                                                                                                                                                                Twelve year study of Pseudomyxoma Peritonei Treatment with CRS and HIPEC
                                                                                                                                                                                Source: San Giuseppe Hospital, June 2009

                                                                                                                                                                                Pleural Pseudomyxoma Peritonei Treatment with Thoracic CRS and HIPEC
                                                                                                                                                                                Source: University of New South Wales, Australia, 2009

                                                                                                                                                                                Pseudomyxoma Peritonei Treatment with CRS and HIPEC
                                                                                                                                                                                Source: Universite de Montreal, Canada, 2009

                                                                                                                                                                                HIPEC Treatment provided at St Agnes
                                                                                                                                                                                Source: Dr Jesus Esquivel

                                                                                                                                                                                Pseudomyxoma Peritonei Treatment with Cytoreductive Surgery and HIPEC
                                                                                                                                                                                Source: British Journal of Surgery, Aug 2008

                                                                                                                                                                                Tailgut Cyst: An Unusual Case of Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Tumori, Dr Paul H Sugarbaker, 2009

                                                                                                                                                                                Pseudomyxoma Peritonei Treatment with Chemo Hyperthermic Perfusion(CHPP)
                                                                                                                                                                                Source: Pub Med 2009

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annuals of Surgical Oncology, 2008
                                                                                                                                                                                International Consensus of PSMG for CRS and HIPEC
                                                                                                                                                                                Source: Springerlink, Oct 2006


                                                                                                                                                                                Recommended Reading:

                                                                                                                                                                                Questions Patients Need to Ask by Dr David Shulkin
                                                                                                                                                                                Source: Amazon.com, Barnes and Noble, Ebay


                                                                                                                                                                                Read ratings for physicians across the USA

                                                                                                                                                                                Alpha Index of  Surgery Articles by "PMP" Cancer Specialists

                                                                                                                                                                                International  listing of research articles and abstracts

                                                                                                                                                                                See our
                                                                                                                                                                                SURGEONS & SPECIALISTS link for additional information about these physicians.
                                                                                                                                                                                We provide the following abstracts and articles, published by, and/or written about the world's most experienced specialists in the treatment and research of Pseudomyxoma Peritonei, and Appendix Cancer. The full titles of some abstracts have been abbreviated due to space limitations.

                                                                                                                                                                                Articles by Dr SA Ahrendt, USA

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis in Colorectal Cancer Patient with Liver Metastasis: Study of 57 Patients
                                                                                                                                                                                Source: Journal of Clinical Oncology 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgical Oncology, 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Colorectal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgial Oncology, Nov 2008

                                                                                                                                                                                Articles by Dr Fernando Arias, Colombia

                                                                                                                                                                                Sleeve Gastrectomy
                                                                                                                                                                                Source: Fundacion Santa Fe de Bogota


                                                                                                                                                                                Abstracts by Dr Mario Baratti, Italy

                                                                                                                                                                                Pseudomyxoma Peritonei Biological Features Are the Dominant Prognostic Determinants After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy
                                                                                                                                                                                Source: Annals of Surgery, Dr Marcello Deraco, Dr Baratti, 2009


                                                                                                                                                                                Articles by Dr David L Bartlett, USA

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis in Colorectal Cancer Patient with Liver Metastasis: Study of 57 Patients
                                                                                                                                                                                Source: Journal of Clinical Oncology 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Anuals of Surgical Oncology, 2008

                                                                                                                                                                                HIPEC: The Complexity of Clinical Trials
                                                                                                                                                                                Source: Dr David L Bartlett, UPMC, Society of Surgical Oncology 2008

                                                                                                                                                                                Dr David L Bartlett, Dr James Pingpank, Dr Steven Ahrendt
                                                                                                                                                                                Source: Koch Cancer Treatment Center, UPMC

                                                                                                                                                                                Profile for Dr David L Bartlett
                                                                                                                                                                                Source: UPMC

                                                                                                                                                                                Dr David L Bartlett:
                                                                                                                                                                                Koch Cancer Center
                                                                                                                                                                                Source: UPMC

                                                                                                                                                                                Dr David L Bartlett: Treatment of Liver Cancer
                                                                                                                                                                                Source: UPMC Koch Cancer Center

                                                                                                                                                                                Articles by Dr Jean Bereder, France
                                                                                                                                                                                Study of 300+ Patients Treated with CRS and PIC
                                                                                                                                                                                Abstract of a study of 300+ Pseudomyxoma Peritonei patients treated with cytoreductive surgery and intraperitoneal chemotherapy. Describes "gold standard " of treatment.
                                                                                                                                                                                Source: Elias D, Gilly F, Quenet F, Bereder JM, Sidéris L, Mansvelt B, Lorimier G, Glehen O; the Association Française de Chirurgie.
                                                                                                                                                                                Department of Oncologic Surgery, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif Cédex, France March 2010

                                                                                                                                                                                Study of 523 Colorectal Peritoneal Carcinomatosis Cases: CRS and IPC
                                                                                                                                                                                Source: Journal of Clinical Oncology,2010

                                                                                                                                                                                Articles by Dr Wim Ceelen, Belgium

                                                                                                                                                                                Dr Wim P Ceelen treats Pseudomyxoma Peritonei with HIPEC www.surgery.ugent.be

                                                                                                                                                                                Articles by Dr Marcello Deraco, Italy

                                                                                                                                                                                Pseudomyxoma PeritoneiBiological Features Are the Dominant Prognostic Determinants After Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy
                                                                                                                                                                                Source: Annals of Surgery, Dr Marcello Deraco, Dr Baratti, 2009


                                                                                                                                                                                HIPEC Treatment: Dott. Marcello Deraco: Pseudomyxoma Peritonei and Appendix Cancer
                                                                                                                                                                                Source: Dott. Marcello Deraco

                                                                                                                                                                                Articles by Dr D Elias, France

                                                                                                                                                                                Study of 523 Colorectal Peritoneal Carcinomatosis Cases: CRS and IPC
                                                                                                                                                                                Source: Journal of Clinical Oncology,2010

                                                                                                                                                                                Articles by Dr Jesus Esquivel, USA

                                                                                                                                                                                Learning Curve for CRS and HIPEC
                                                                                                                                                                                Source: Journal of Surgical Oncology, August 2009


                                                                                                                                                                                Laparoscopic CRS and HIPEC Treatment for Peritoneal Mesothelioma
                                                                                                                                                                                Source: Dr Jesus Esquivel, 2009

                                                                                                                                                                                HIPEC Treatment available at St Agnes Hospital
                                                                                                                                                                                Source: Dr Jesus Esquivel

                                                                                                                                                                                Pros and Cons of HIPEC: Dr Jesus Esquivel
                                                                                                                                                                                Source: Oncology Times, Jan 2007

                                                                                                                                                                                Physician Profile for Dr Jesus Esquivel
                                                                                                                                                                                Source: St Agnes Hospital

                                                                                                                                                                                Dr Jesus Esquivel:
                                                                                                                                                                                St Agnes Hospital
                                                                                                                                                                                Source: St Agnes Hospital

                                                                                                                                                                                Articles by Dr Jan Franko, USA

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis in Colorectal Cancer Patient with Liver Metastasis: Study of 57 Patients
                                                                                                                                                                                Source: Journal of Clinical Oncology 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgical Oncology, 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Colorectal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgial Oncology, Nov 2008

                                                                                                                                                                                Click here to read Dr Jan Franko's profile
                                                                                                                                                                                Source: Mercy Medical Center

                                                                                                                                                                                Articles by Dr Gilly, France
                                                                                                                                                                                Study of 300+ Patients Treated with CRS and PIC :
                                                                                                                                                                                Abstract of a study of 300+ Pseudomyxoma Peritonei patients treated with cytoreductive surgery and intraperitoneal chemotherapy. Describes "gold standard " of treatment.
                                                                                                                                                                                 
                                                                                                                                                                                Source: Elias D, Gilly F, Quenet F, Bereder JM, Sidéris L, Mansvelt B, Lorimier G, Glehen O; the Association Française de Chirurgie.
                                                                                                                                                                                Department of Oncologic Surgery, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif Cédex, France March 2010

                                                                                                                                                                                Study of 523 Colorectal Peritoneal Carcinomatosis Cases: CRS and IPC
                                                                                                                                                                                Source: Journal of Clinical Oncology,2010

                                                                                                                                                                                Articles by Dr Matthew Holtzman, USA

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis in Colorectal Cancer Patient with Liver Metastasis: Study of 57 Patients Source: Journal of Clinical Oncology 2008

                                                                                                                                                                                Articles by Dr Joachim Jahne, Germany

                                                                                                                                                                                CRS:Stategies to Reduce Post Op Morbidity and Complications
                                                                                                                                                                                Source: Dr Joachim Jahne, April 2009


                                                                                                                                                                                Articles by Dr Santiago Gonzalez-Moreno, Spain

                                                                                                                                                                                Patient Selection for CRS and HIPEC
                                                                                                                                                                                Source: Journal of Surgical Oncology 2009

                                                                                                                                                                                Articles by Dr Martin Goodman, USA

                                                                                                                                                                                Dr Martin Goodman at Tufts University provides HIPEC
                                                                                                                                                                                Source: Tufts University, Boston

                                                                                                                                                                                Articles by Dr Matthew Holtzman, USA

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgical Oncology, 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Colorectal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgial Oncology, Nov 2008

                                                                                                                                                                                Articles by Dr Laura Lambert, USA

                                                                                                                                                                                CRS and Perioperative Intraperitoneal Chemotherapy for Colorectal Carcinomatosis:
                                                                                                                                                                                Source: Annals of Surgical Oncology. 2007, Lambert, Laura A. and Paul F. Mansfield. 
                                                                                                                                                                                See:
                                                                                                                                                                                http://www.annalssurgicaloncology.org/cgi/content/full/14/11/3037


                                                                                                                                                                                Articles by Dr Edward Levine, USA

                                                                                                                                                                                CRS and HIPEC for the Treatment of Peritoneal Dissemination of Appendiceal and Colorectal Neoplasms
                                                                                                                                                                                Source: Dr Edward Levine, ASCO 2008

                                                                                                                                                                                “Appendiceal Carcinoma with Peritoneal Dissemination: Outcomes for the Best of the Best.” 
                                                                                                                                                                                Source: Annals of Surgical
                                                                                                                                                                                Oncology,2007, Dr Edward Levine, WFU

                                                                                                                                                                                Survival Study for Pseudomyxoma Peritonei: DPAM, PMCA, PMCA 1
                                                                                                                                                                                Source: Dr Edward Levine, American Journal of Surgical Pathology, May 2006

                                                                                                                                                                                DPAM and HIPEC Treatment
                                                                                                                                                                                Source: Wake Forest University


                                                                                                                                                                                Articles by Dr Brian W Loggie, USA

                                                                                                                                                                                CRS with HIPEC have improved quality and quantity of life for patients
                                                                                                                                                                                Source:Dr Brian Loggie, 2007

                                                                                                                                                                                Cox II expression in patients with Pseudomyxoma Peritonei and Disseminated Peritoneal Adenomucinosis
                                                                                                                                                                                Source: Dr Brian Loggie

                                                                                                                                                                                Articles referring to Dr Brian Loggie's patients
                                                                                                                                                                                Source: PMP Pals' Network


                                                                                                                                                                                Articles by Dr Andrew Lowy, USA

                                                                                                                                                                                Minimally Invasive Laparoscopic Treatment of Pseudomyxoma Peritonei
                                                                                                                                                                                Source: UCSD, Dr Andrew Lowy, 2009


                                                                                                                                                                                Dr Andrew Lowy:Moores Cancer Center
                                                                                                                                                                                Source: UCSD

                                                                                                                                                                                Treatment of Pancreatic Cancer
                                                                                                                                                                                Source: Dr Andrew Lowy UCSD

                                                                                                                                                                                Articles by Dr Paul Mansfield, USA

                                                                                                                                                                                Profile for Dr Paul Mansfield
                                                                                                                                                                                Source: MD Anderson

                                                                                                                                                                                CRS and HIPEC for the Treatment of Peritoneal Dissemination of Appendiceal and Colorectal Neoplasms

                                                                                                                                                                                Source: Dr Paul Mansfield, ASCO 2008

                                                                                                                                                                                CRS and Perioperative Intraperitoneal Chemotherapy for Colorectal Carcinomatosis:
                                                                                                                                                                                Source:
                                                                                                                                                                                Annals of Surgical Oncology. 2007, Lambert, Laura A. and Paul F. Mansfield. 
                                                                                                                                                                                See:
                                                                                                                                                                                http://www.annalssurgicaloncology.org/cgi/content/full/14/11/3037

                                                                                                                                                                                Laparoscopic Staging for Gastric Cancer
                                                                                                                                                                                Source: Dr Paul Mansfield, MDACC, Annals of Surgical Oncology, 2001


                                                                                                                                                                                Laparoscopy for Surgical Oncology
                                                                                                                                                                                Source: MDACC


                                                                                                                                                                                Articles by Dr Brendan J Moran, United Kingdom

                                                                                                                                                                                CRS and HIPEC for the Treatment of Patients age 30-77 years
                                                                                                                                                                                Source: North Hampshire Hospital, Basingstoke UK, 2007

                                                                                                                                                                                Articles by Prof David L Morris, Australia 
                                                                                                                                                                                Radiofrequency Ablation for Treatment of Unresectable Colorectal Pulmonary Metastes

                                                                                                                                                                                Radiofrequency ablation as an adjunct to systemic chemotherapy for colorectal pulmonary metastases. Radiofrequency ablation for colorectal pulmonary metastases represents a step forward towards a nonsurgical option of combining systemic and local treatment for metastatic disease and is a safe treatment with a low risk profile.
                                                                                                                                                                                Source: David L. Morris, MD, PhD 2009

                                                                                                                                                                                Morbidity and Mortality: Study of HIPEC and CRS for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgery, Feb 2009, Dr David Morris, Dr Tristan Yan

                                                                                                                                                                                DPAM: Peritonectomy Improves Survival

                                                                                                                                                                                Source Prof David L Morris, 2009

                                                                                                                                                                                Assessment of risk factors following CRS and chemotherapy
                                                                                                                                                                                Source: Dr David L Morris, Dr Tristan Yan, 2009
                                                                                                                                                                                Cost effectiveness of treatment with CRS and HIPEC
                                                                                                                                                                                Source: Dr David L Morris, Dr Tristan Yan, Dec 2009

                                                                                                                                                                                Pseudomyxoma Peritonei Long Term Survival (10 year study) 
                                                                                                                                                                                Source: Annals of Surgical Oncology, 2009, Prof David L Morris, St George Hospital,Univ of New South Wales, Sydney, NSW, AU

                                                                                                                                                                                Long-term survival in patients with pseudomyxoma peritonei treated with cytoreductive surgery and perioperative intraperitoneal chemotherapy: 10 years of experience. 

                                                                                                                                                                                This report demonstrates long-term survival outcomes, acceptable perioperative outcomes, and a learning curve associated with the treatment of patients with pseudomyxoma peritonei.

                                                                                                                                                                                In vivo model for Pseudomyxoma Peritonei research
                                                                                                                                                                                Source: Prof David L Morris, Sydney Australia, 2009

                                                                                                                                                                                Articles by Dr Stefaan Mulier, Belgium

                                                                                                                                                                                Dr Stefaan Mulier provides HIPEC treatment for Pseudomyxoma Peritonei and Peritoneal Carcinomatosis 
                                                                                                                                                                                Source: Leopold Park Clinic in Brussels


                                                                                                                                                                                Articles by Dr Herwart Mueller, German

                                                                                                                                                                                CRS for Senior Patients
                                                                                                                                                                                Source: Dr Herwart Mueller, Germany

                                                                                                                                                                                Articles by Dr Garrett M Nash USA

                                                                                                                                                                                Laparoscopic Surgery for the Treatment of Peritoneal Surface Malignancies including Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Memorial Sloan Kettering, NY

                                                                                                                                                                                Articles by Dr Haydee Ojeda-Fournier, USA   

                                                                                                                                                                                Diagnostic Imaging of Pancreatic Cancer
                                                                                                                                                                                Source: Dr Haydee Ojeda-Fournier, UCSD

                                                                                                                                                                                Articles by Dr Gloria Ortega-Perez, Spain

                                                                                                                                                                                Patient Selection for CRS and HIPEC
                                                                                                                                                                                Source: Journal of Surgical Oncology 2009


                                                                                                                                                                                Articles by Dr James Pingpank, USA

                                                                                                                                                                                Peritoneal Carcinomatois Clinical Trials Study
                                                                                                                                                                                Source: NIH, Dr James Pingpank, Feb 2009


                                                                                                                                                                                Articles by Prof Pompiliu Piso, Germany

                                                                                                                                                                                Peritoneal Carcinomatosis Treatment (Study) with Tumor Honing Peptides
                                                                                                                                                                                Source: Dept of Radiology, Germany 2009

                                                                                                                                                                                Peritoneal Carcinomatosis Prognosis following treatment with surgery and HIPEC
                                                                                                                                                                                Source: Prof P Piso, 2009

                                                                                                                                                                                CRS and HIPEC for the Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Prof Pompiliu Piso, 3rd Annual Symposium, 2008

                                                                                                                                                                                HIPEC Study with laboratory rats
                                                                                                                                                                                Source: Deutscher Krebskongress, 2004

                                                                                                                                                                                Articles by Dr B Ronnett, USA

                                                                                                                                                                                CRS and HIPEC for the Treatment of Peritoneal Dissemination of Appendiceal and Colorectal Neoplasms
                                                                                                                                                                                Source: Dr Edward Levine, ASCO 2008

                                                                                                                                                                                DPAM Long Term Survival
                                                                                                                                                                                Source: Dr BM Ronnett, Dr Paul H Sugarbaker, 2009

                                                                                                                                                                                Articles by Dr Armando Sardi, USA

                                                                                                                                                                                CRS and HIPEC offer longterm survival for Peritoneal Carcinomatosis of disseminated Appendiceal tumor origin
                                                                                                                                                                                Source: Dr Armando Sardi, Mercy Med Center, Journal of American College of Surgeons, Sept 2009

                                                                                                                                                                                Published abstracts by Dr Armando Sardi
                                                                                                                                                                                Source: Mercy Medical Center


                                                                                                                                                                                Steps to Prepare for SurgerySource: Mercy Medical Center

                                                                                                                                                                                Curriculum Vitae for Dr Armando Sardi
                                                                                                                                                                                Source: Mercy Medical Center

                                                                                                                                                                                Profile for Dr Armando Sardi
                                                                                                                                                                                Source: Mercy Medical Center


                                                                                                                                                                                Articles by Dr Perry Shen, USA

                                                                                                                                                                                Dr Perry Shen at WFU provides HIPEC
                                                                                                                                                                                Source: Wake Forest University

                                                                                                                                                                                Articles by Dr Paul H Sugarbaker, USA

                                                                                                                                                                                Mesenteric Cyst resulting in Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, 2010

                                                                                                                                                                                Tailgut Cyst: An Unusual Case of Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Tumori, Dr Paul H Sugarbaker, 2009

                                                                                                                                                                                Epithelial appendiceal neoplasms (abstract with availability to purchase article in full)
                                                                                                                                                                                Source: The Cancer Journal, 2009

                                                                                                                                                                                Epithelial appendiceal neoplasms: report reviews 900 cases treated at the Washington Hospital Center
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, Cancer Journal, May 2009

                                                                                                                                                                                DPAM Long Term Survival
                                                                                                                                                                                Source: Dr BM Ronnett, Dr Paul H Sugarbaker, 2009

                                                                                                                                                                                Management of mucinous urachal neoplasm presenting as Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, 2008

                                                                                                                                                                                Failure Analysis of Recurrent Disease Following CRS and IPC for Colorectal Cancer with Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, Dr Tristan Yan, 2007

                                                                                                                                                                                Treatment of Peritoneal Surface Malignancy
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, Dr Tristan Yan, Journal of Transistional Medicine, 2006

                                                                                                                                                                                Cytoreductive Surgery (includes graphic illustrations) Source: Dr Paul H Sugarbaker

                                                                                                                                                                                Indications for use of CRS and HIPEC
                                                                                                                                                                                Source: Dr Paul H Sugarbaker

                                                                                                                                                                                Appendix Cancer Prognosis
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, Washington Hospital Center

                                                                                                                                                                                Prognostic indicators for Peritoneal Carcinomatosis originating with gastrointestinal adenocarcinoma
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, 2005

                                                                                                                                                                                Atlas of Appendix Cancer(includes graphic illustrations)
                                                                                                                                                                                Source: Dr Paul H  Sugarbaker


                                                                                                                                                                                Articles referring to Dr Paul Sugarbaker and his patients
                                                                                                                                                                                Source: PMP Pals' Network

                                                                                                                                                                                Articles by Dr V J Verwaal,Holland

                                                                                                                                                                                Population Based Study of Appendiceal Neoplasms and Pseudomyxoma Peritonei
                                                                                                                                                                                Source: ESJO, 2008


                                                                                                                                                                                Cytoreduction and HIPEC Treatment for Appendix Cancer and Pseudomyxoma Peritonei (pdf)
                                                                                                                                                                                Source: Netherlands Cancer Institute, Prof VJ Verwaal, 2006

                                                                                                                                                                                Articles by Dr Tristan Yan, Australia

                                                                                                                                                                                Cost effectiveness of treatment with CRS and HIPEC
                                                                                                                                                                                Source: Dr David L Morris, Dr Tristan Yan, Dec 2009

                                                                                                                                                                                Morbidity and Mortality: Study of HIPEC and CRS for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgery, Feb 2009, Dr David Morris, Dr Tristan Yan

                                                                                                                                                                                Assessment of risk factors following CRS and chemotherapy
                                                                                                                                                                                Source: Dr David L Morris, Dr Tristan Yan, 2009
                                                                                                                                                                                Failure Analysis of Recurrent Disease Following CRS and IPC for Colorectal Cancer with Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, Dr Tristan Yan, 2007

                                                                                                                                                                                Treatment of Peritoneal Surface Malignancy
                                                                                                                                                                                Source: Dr Paul H Sugarbaker, Dr Tristan Yan, Journal of Transistional Medicine, 2006

                                                                                                                                                                                Articles by Dr H Zeh, USA

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis in Colorectal Cancer Patient with Liver Metastasis: Study of 57 Patients
                                                                                                                                                                                Source: Journal of Clinical Oncology 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgical Oncology, 2008

                                                                                                                                                                                CRS and HIPEC for Treatment of Colorectal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgial Oncology, Nov 2008

                                                                                                                                                                                Articles by Dr F Zoetmulder, Holland

                                                                                                                                                                                Population Based Study of Appendiceal Neoplasms and Pseudomyxoma Peritonei
                                                                                                                                                                                Source: ESJO, 2008


                                                                                                                                                                                Cytoreductive Surgery in conjunction with HIPEC

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                                                                                                                                                                                CRS (Cytoreductive Surgery) in conjunction with HIPEC:
                                                                                                                                                                                Articles
                                                                                                                                                                                 and Abstracts


                                                                                                                                                                                Study of 300+ Patients Treated with CRS and PIC
                                                                                                                                                                                Abstract of a study of 300+ Pseudomyxoma Peritonei patients treated with cytoreductive surgery and intraperitoneal chemotherapy. Describes "gold standard " of treatment.
                                                                                                                                                                                Source: Elias D, Gilly F, Quenet F, Bereder JM, Sidéris L, Mansvelt B, Lorimier G, Glehen O; the Association Française de Chirurgie.
                                                                                                                                                                                Department of Oncologic Surgery, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif Cédex, France March 2010

                                                                                                                                                                                Radiofrequency Ablation for Treatment of Unresectable Colorectal Pulmonary Metastes


                                                                                                                                                                                Radiofrequency ablation as an adjunct to systemic chemotherapy for colorectal pulmonary metastases. Radiofrequency ablation for colorectal pulmonary metastases represents a step forward towards a nonsurgical option of combining systemic and local treatment for metastatic disease and is a safe treatment with a low risk profile.

                                                                                                                                                                                Terence C. Chua, BScMed (Hons), MBBS 1, Kelly Thornbury, BMed 1, Akshat Saxena, BMedSc 1, Winston Liauw, MBBS, M Med Sci 2, Derek Glenn, MBBS 3, Jing Zhao, MD 1, David L. Morris, MD, PhD 1 *
                                                                                                                                                                                1Department of Surgery, University of New South Wales, St George Hospital, Sydney, Australia
                                                                                                                                                                                2Cancer Care Center, St George Hospital, Sydney, Australia
                                                                                                                                                                                3Department of Radiology, St George Hospital, Sydney, Australia
                                                                                                                                                                                Source: AMC Feb 2010 

                                                                                                                                                                                Treatment of Peritoneal Malignancies, including Pseudomyxoma Peritonei with CRS and HIPEC

                                                                                                                                                                                CONCLUSION: It is important to recognize the role of and indications for CRS and HIPEC. Biologic factors of the disease and completeness of resection are important prognostic factors. Cytoreductive surgery, combined with intraperitoneal chemotherapy, can improve survival in selected patients with peritoneal-based malignancies.

                                                                                                                                                                                Source:Department of Surgical Oncology, National Cancer Centre of Singapore, Singapore 2010

                                                                                                                                                                                Study of 523 Colorectal Peritoneal Carcinomatosis Cases: CRS and IPC
                                                                                                                                                                                Source: Journal of Clinical Oncology,2010

                                                                                                                                                                                12 Year Study of CRS and HIPEC for Pseudomyxoma Peritonei Treatment
                                                                                                                                                                                Source: In Vivo, 2009


                                                                                                                                                                                Morbidity and Mortality: Study of HIPEC and CRS for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annals of Surgery, Feb 2009, Dr David Morris, Dr Tristan Yan



                                                                                                                                                                                CRS with HIPEC have improved quality and quantity of life for patients
                                                                                                                                                                                Source:Dr Brian Loggie, 2007

                                                                                                                                                                                HIPEC: Complexity
                                                                                                                                                                                Source: Dr David L Bartlett,Journal of Surgical Oncology

                                                                                                                                                                                Twelve year study of Pseudomyxoma Peritonei Treatment with CRS and HIPEC
                                                                                                                                                                                Source: San Giuseppe Hospital, June 2009

                                                                                                                                                                                Pleural Pseudomyxoma Peritonei Treatment with Thoracic CRS and HIPEC
                                                                                                                                                                                Source: University of New South Wales, Australia, 2009

                                                                                                                                                                                Pseudomyxoma Peritonei Treatment with CRS and HIPEC
                                                                                                                                                                                Source: Universite de Montreal, Canada, 2009

                                                                                                                                                                                HIPEC Treatment provided at St Agnes
                                                                                                                                                                                Source: Dr Jesus Esquivel

                                                                                                                                                                                Pseudomyxoma Peritonei Treatment with Cytoreductive Surgery and HIPEC
                                                                                                                                                                                Source: British Journal of Surgery, Aug 2008

                                                                                                                                                                                Tailgut Cyst: An Unusual Case of Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Tumori, Dr Paul H Sugarbaker, 2009

                                                                                                                                                                                Pseudomyxoma Peritonei Treatment with Chemo Hyperthermic Perfusion(CHPP)
                                                                                                                                                                                Source: Pub Med 2009

                                                                                                                                                                                CRS and HIPEC for Treatment of Peritoneal Carcinomatosis
                                                                                                                                                                                Source: Annuals of Surgical Oncology, 2008
                                                                                                                                                                                International Consensus of PSMG for CRS and HIPEC
                                                                                                                                                                                Source: Springerlink, Oct 2006


                                                                                                                                                                                Laparoscopy; Minimally Invasive Staging and Surgery

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                                                                                                                                                                                Laparoscopy surgery
                                                                                                                                                                                includes the use of a thin, narrow, tube shaped instrument inserted into the abdominal wall. Laparoscopy may be used as a diagnostic tool, and has become a surgical option for specific patients, providing a less invasive (and less expensive) alternative to more extensive surgery. Recuperation from laparoscopy requires less hospitalization due to a faster recovery period, with less trauma and post op pain.

                                                                                                                                                                                The following articles and abstracts pertaining to mesothelioma, pseudomyxoma peritonei, gastric, liver, ovarian and pancreatic cancer are posted for your reference.
                                                                                                                                                                                 


                                                                                                                                                                                Laparoscopy for Oncological Surgery (this article provides a detailed explanation for patients)
                                                                                                                                                                                Source: MDAnderson, Houston TX

                                                                                                                                                                                Laparoscopic Mucin Removal of Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Dept of OB GYN, Kinko Univ, Osaka Japan, 2009

                                                                                                                                                                                Minimally Invasive Laparoscopic Surgery
                                                                                                                                                                                Source: Mercy Medical Center

                                                                                                                                                                                Minimally Invasive Laparoscopic Surgery, Liver, Pancreas
                                                                                                                                                                                Source: UCSD, Dr Andrew Lowy, 2009

                                                                                                                                                                                Laparoscopic CRS and HIPEC Treatment for Peritoneal Mesothelioma
                                                                                                                                                                                Source: Dr Jesus Esquivel, 2009

                                                                                                                                                                                Laparoscopic Surgery for the Treatment of Peritoneal Surface Malignancies including Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Memorial Sloan Kettering, NY

                                                                                                                                                                                Laparoscopic Surgery for the Treatment of Liver Cancer, Pancreas Cancer
                                                                                                                                                                                Source: University of Southern California


                                                                                                                                                                                Laparoscopic Staging for Gastric Cancer
                                                                                                                                                                                Source: Dr Paul Mansfield, MDACC, Annals of Surgical Oncology, 2001


                                                                                                                                                                                Laparoscopic Colon Resection
                                                                                                                                                                                Source: UPMC Koch Cancer Treatment Center


                                                                                                                                                                                Laparoscopic Surgery for Liver Cancer
                                                                                                                                                                                Source: Dr David L Bartlett UPMC Koch Cancer Center

                                                                                                                                                                                Laparoscopic Surgery for Whipple Procedure, Pancreatic
                                                                                                                                                                                Source: USC Norris Cancer Center


                                                                                                                                                                                Laparoscopic Surgery, Gastric and Esophageal Cancers
                                                                                                                                                                                Source: Dr Charles Filipi, Creighton University


                                                                                                                                                                                Laparoscopic restoration of the colon continuity after Hartmann procedure
                                                                                                                                                                                Source: Pub Med 2009

                                                                                                                                                                                Laparoscopic Management of Ovarian Cyst
                                                                                                                                                                                Source: Springerlink:2008

                                                                                                                                                                                Laparoscopic Management of Pseudomyxoma Peritonei
                                                                                                                                                                                Source: Cleveland Clinic 1999


                                                                                                                                                                                Cecum Preserving Right Hemicolectomy
                                                                                                                                                                                Source: Clinical Robotics, 2010

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