There is new hope for some of the most seriously ill colon cancer patients today, following the release of a consensus statement by 72 leading oncology surgeons from 14 countries, including the United States. The Peritoneal Surface Malignancy Group (PSMG), including doctors from the University of Pittsburgh Medical Center, Baylor University Medical Center in Dallas; H. Lee Moffitt Cancer Center in Tampa; Walter Reed Army Medical Center in Washington; and St. Agnes Hospital in Baltimore, has concluded that surgery, followed by heated chemotherapy delivered through the lower abdomen of the patient before leaving the operating room, may significantly increase the life expectancy for patients with Stage IV colorectal cancer.
The heated chemotherapy is designed to help reliably attack any residual cancer cells remaining after surgery. The consensus statement: "Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Management of Peritoneal Surface Malignancies of Colonic Origin", appears on the Web site for the Annals of Surgical Oncology.
HIPEC involves the use of conventional chemotherapy drugs heated to such a high temperature as to kill cancer cells. Additionally, by bathing the abdomen with heated chemotherapy immediately following surgery, a higher dose of medication can be used than would normally be tolerated by a patient if given intravenously -- the traditional way chemotherapy is administered. Before releasing today's consensus statement, the PSMG reviewed several peer-reviewed clinical articles published by nationally renowned oncology researchers and surgeons to establish standardized methods to deliver HIPEC; define patient selection criteria; and improve surgical techniques.
In 2005, an estimated 145,000 new cases of colorectal cancer were diagnosed in the United States, according to the American Cancer Society. Doctors estimate 30 percent of these patients would benefit from surgery with HIPEC. The published data on the treatment of patients with Stage IV colorectal cancer, with combinations of tumor removal surgery and chemotherapy, showed a median survival of greater than 20 months, compared to six-month survival with traditional intravenous chemotherapy alone.
"HIPEC is an aggressive surgical treatment for end-stage cancer patients, with promising results," says Jesus Esquivel, M.D., lead author of the consensus statement and director of the peritoneal surface malignancy program at St. Agnes Healthcare in Baltimore. "This innovative therapy, with surgery, is helping to significantly improve, and extend the lives of patients who are in desperate need."
Patients whose colon cancer recurs, and those with cancer that has spread to other parts of the body, involving the abdomen or peritoneal cavity, are the patients who benefited most from the combination of surgery followed by HIPEC. Although not addressed in the consensus statement, surgical oncologists are utilizing the treatment for patients with other forms of abdominal cancers, including pancreatic, ovarian, and gastric cancer.
The PSMG is currently 72 national and international surgical oncologists from 55 cancer centers in 14 countries, who are dedicated to education, research, and improved care for patients with advanced abdominal cancers.
Materials provided by Weill Cornell Medical College. Note: Content may be edited for style and length.
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