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Article: Appendiceal Mucinous Neoplasms: From Clinic to Pathology and Prognosis.

González Bayón, Luis / Martín Román, Lorena / Lominchar, Pablo Lozano

2023 Volume 15, Issue 13

Abstract: Appendiceal mucinous neoplasms have been classified differently over time causing confusion when comparing results between working groups in this field and establishing a prognosis of the disease. A historical perspective of the different classification ... ...

Abstract	Appendiceal mucinous neoplasms have been classified differently over time causing confusion when comparing results between working groups in this field and establishing a prognosis of the disease. A historical perspective of the different classification systems of these tumors is essential for the understanding of the evolution of concepts and histopathological definitions that have led up to the present moment. We carried out a systematic review of the pathological classifications of appendiceal mucinous tumors and how they have included the new criteria resulting from clinical and pathological research. The latest classifications by PSOGI and AJCC 8th edition Cancer Staging have made a great effort to incorporate the new pathological descriptions and develop prognostic groups. The introduction of these new classification systems has posed the challenge of verifying how they adapt to our casuistry and which one defines best the prognosis of our patients. We reclassified our series of patients treated for mucinous appendiceal tumors with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy following the PSOGI and the AJCC 8th edition criteria and concluded that both classifications correspond well with the OS and DFS of these patients, with some advantage relative to the PSOGI classification due to a better histopathological description of the different groups.
Language	English
Publishing date	2023-06-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15133426
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Article ; Online: ASO Author Reflections: Predicting Prognosis in Patients with Pseudomyxoma.

Martín Román, Lorena / Lozano Lominchar, Pablo / Baratti, Dario / Vásquez, Wencesalo / González Bayón, Luis

Annals of surgical oncology

2022 Volume 29, Issue 12, Page(s) 7564–7565

MeSH term(s)	Humans ; Peritoneal Neoplasms ; Prognosis ; Pseudomyxoma Peritonei/surgery
Language	English
Publishing date	2022-07-27
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-12287-5
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Article ; Online: Recommendations for the optimal management of peritoneal metastases in patients with colorectal cancer: a TTD and GECOP-SEOQ expert consensus statement.

Grávalos, Cristina / Pereira, Fernando / Vera, Ruth / Arjona-Sánchez, Alvaro / Losa, Ferran / Ramos, Isabel / García-Alfonso, Pilar / Gonzalez-Bayón, Luis / Cascales-Campos, Pedro Antonio / Aranda, Enrique

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2023 Volume 25, Issue 12, Page(s) 3378–3394

Abstract: Peritoneal metastases (PM) occur when cancer cells spread inside the abdominal cavity and entail an advanced stage of colorectal cancer (CRC). Prognosis, which is poor, correlates highly with tumour burden, as measured by the peritoneal cancer index (PCI) ...

Abstract	Peritoneal metastases (PM) occur when cancer cells spread inside the abdominal cavity and entail an advanced stage of colorectal cancer (CRC). Prognosis, which is poor, correlates highly with tumour burden, as measured by the peritoneal cancer index (PCI). Cytoreductive surgery (CRS) in specialized centres should be offered especially to patients with a low to moderate PCI when complete resection is expected. The presence of resectable metastatic disease in other organs is not a contraindication in well-selected patients. Although several retrospective and small prospective studies have suggested a survival benefit of adding hyperthermic intraperitoneal chemotherapy (HIPEC) to CRS, the recently published phase III studies PRODIGE-7 in CRC patients with PM, and COLOPEC and PROPHYLOCHIP in resected CRC with high-risk of PM, failed to show any survival advantage of this strategy using oxaliplatin in a 30-min perfusion. Final results from ongoing randomized phase III trials testing CRS plus HIPEC based on mitomycin C (MMC) are awaited with interest. In this article, a group of experts selected by the Spanish Group for the Treatment of Digestive Tumours (TTD) and the Spanish Group of Peritoneal Oncologic Surgery (GECOP), which is part of the Spanish Society of Surgical Oncology (SEOQ), reviewed the role of HIPEC plus CRS in CRC patients with PM. As a result, a series of recommendations to optimize the management of these patients is proposed.
MeSH term(s)	Humans ; Colorectal Neoplasms/pathology ; Peritoneal Neoplasms/secondary ; Retrospective Studies ; Prospective Studies ; Combined Modality Therapy ; Hyperthermia, Induced/methods ; Survival Rate
Language	English
Publishing date	2023-05-04
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-023-03204-7
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Article ; Online: Which classification system defines best prognosis of mucinous neoplasms of the appendix with peritoneal dissemination: TNM vs PSOGI?

Martín-Román, Lorena / Lozano, Pablo / Gómez, Yesica / Fernández-Aceñero, María Jesús / Vasquez, Wenceslao / Palencia, Natividad / González-Bayón, Luis

Journal of clinical pathology

2021 Volume 76, Issue 4, Page(s) 266–273

Abstract: Aims: Several classification systems are used for pseudomyxoma peritonei. The four-tiered classification system proposed by Peritoneal Surface Oncology Group International (PSOGI) and the two-tiered proposed by the eighth edition of the American Joint ... ...

Abstract	Aims: Several classification systems are used for pseudomyxoma peritonei. The four-tiered classification system proposed by Peritoneal Surface Oncology Group International (PSOGI) and the two-tiered proposed by the eighth edition of the American Joint Committee on Cancer (AJCC) result from evolution in terminology and pathological insight. The aim is to evaluate the impact of PSOGI and eighth edition of the AJCC classifications on survival. Methods: Pathological slides were reviewed from a prospectively maintained database including patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for an appendiceal mucinous neoplasm with peritoneal dissemination between January 2009 and December 2019. Patients were reclassified according to PSOGI and AJCC eighth edition criteria. Survival analysis evaluated the impact of each classification system on overall survival (OS) and disease-free survival (DFS) while the concordance-index evaluated their predictive power. Results: 95 patients were identified; 21.1% were reclassified as acellular mucin, 55.8% as low-grade mucinous carcinoma peritonei, 8.4% as high-grade MCP (HGMCP) and 14 as HGMCP with signet ring cells. Median OS was not reached, 5-year OS and DFS were 86.1% and 51.5%, respectively. Multivariate analysis revealed significant associations with OS (PSOGI: HR 10.2, p=0.039; AJCC: HR 7.7, p=0.002) and DFS (PSOGI: HR 12.7, p=0.001; AJCC: HR 3.7, p<0.001). The predictive capacity of both classification systems was unacceptable for OS and DFS (concordance-index values <0.7). Conclusions: Both classification systems behaved similarly when stratifying our series into prognostic groups. The PSOGI classification provides better histopathological description, but histology alone is insufficient for adequate patient prognostication.
MeSH term(s)	Humans ; Appendix/pathology ; Peritoneal Neoplasms/therapy ; Peritoneal Neoplasms/pathology ; Appendiceal Neoplasms/therapy ; Appendiceal Neoplasms/pathology ; Pseudomyxoma Peritonei/therapy ; Neoplasms, Cystic, Mucinous, and Serous ; Prognosis ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2021-11-01
Publishing country	England
Document type	Journal Article
ZDB-ID	80261-x
ISSN	1472-4146 ; 0021-9746
ISSN (online)	1472-4146
ISSN	0021-9746
DOI	10.1136/jclinpath-2021-207883
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Article ; Online: ESTRO/ACROP IORT recommendations for intraoperative radiation therapy in locally recurrent rectal cancer.

Calvo, Felipe A / Sole, Claudio V / Rutten, Harm J / Dries, Wim J / Lozano, Miguel A / Cambeiro, Mauricio / Poortmans, Philip / González-Bayón, Luis

Clinical and translational radiation oncology

2020 Volume 24, Page(s) 41–48

Abstract: Multimodal strategies have been implemented for locally recurrent rectal cancer scheduled for complete surgical resection. Irradiation and systemic therapy have been added to improve the oncological outcome, as surgery alone was associated with a poor ... ...

Abstract	Multimodal strategies have been implemented for locally recurrent rectal cancer scheduled for complete surgical resection. Irradiation and systemic therapy have been added to improve the oncological outcome, as surgery alone was associated with a poor prognosis. Intraoperative irradiation (IORT) is a component of irradiation intensification. Long-term cancer control and a higher survival rate were consistently reported in patients who had IORT as a component of their multidisciplinary treatment. The experience reported by expert IORT groups is reviewed and recommendations to guide clinical practice are explained in detail.
Language	English
Publishing date	2020-06-17
Publishing country	Ireland
Document type	Journal Article ; Review
ISSN	2405-6308
ISSN (online)	2405-6308
DOI	10.1016/j.ctro.2020.06.007
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Article ; Online: Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy.

Zaballos, Matilde / Power, Mercedes / Canal-Alonso, María Iluminada / González-Nicolás, María Ángeles / Vasquez-Jimenez, Wenceslao / Lozano-Lominchar, Pablo / Cabrerizo-Torrente, Pilar / Palencia-García, Natividad / Gago-Quiroga, Susana / Ginel-Feito, María Dolores / Jiménez, Consuelo / Lázaro, Alberto / González-Bayón, Luis

International journal of molecular sciences

2021 Volume 22, Issue 3

Abstract: Cisplatin is one of the most widely used chemotherapeutic agents in oncology, although its nephrotoxicity limits application and dosage. We present the results of a clinical study on prophylaxis of cisplatin-induced nephrotoxicity in patients with ... ...

Abstract	Cisplatin is one of the most widely used chemotherapeutic agents in oncology, although its nephrotoxicity limits application and dosage. We present the results of a clinical study on prophylaxis of cisplatin-induced nephrotoxicity in patients with peritoneal carcinomatosis undergoing cytoreduction and hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC-cisplatin). Prophylaxis was with imipenem/cilastatin. Cilastatin is a selective inhibitor of renal dehydropeptidase I in the proximal renal tubule cells that can reduce the nephrotoxicity of cisplatin. Unfortunately, cilastatin is not currently marketed alone, and can only be administered in combination with imipenem. The study has a retrospective part that serves as a control (
MeSH term(s)	Adult ; Aged ; Antineoplastic Agents/therapeutic use ; Cilastatin/pharmacology ; Cilastatin/therapeutic use ; Cisplatin/adverse effects ; Combined Modality Therapy/methods ; Creatinine/blood ; Female ; Humans ; Hyperthermic Intraperitoneal Chemotherapy/adverse effects ; Hyperthermic Intraperitoneal Chemotherapy/methods ; Imipenem/pharmacology ; Imipenem/therapeutic use ; Kidney/drug effects ; Male ; Middle Aged ; Peritoneal Neoplasms/complications ; Peritoneal Neoplasms/drug therapy ; Peritoneal Neoplasms/mortality ; Prospective Studies ; Renal Insufficiency/complications ; Renal Insufficiency/etiology ; Renal Insufficiency/prevention & control ; Retrospective Studies
Chemical Substances	Antineoplastic Agents ; Cilastatin (141A6AMN38) ; Imipenem (71OTZ9ZE0A) ; Creatinine (AYI8EX34EU) ; Cisplatin (Q20Q21Q62J)
Language	English
Publishing date	2021-01-27
Publishing country	Switzerland
Document type	Clinical Study ; Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms22031239
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Article ; Online: Hyperthermic intraperitoneal chemotherapy: methodology and safety considerations.

González-Moreno, Santiago / González-Bayón, Luis / Ortega-Pérez, Gloria

Surgical oncology clinics of North America

2012 Volume 21, Issue 4, Page(s) 543–557

Abstract: Several methods of delivering hyperthermic intraperitoneal chemotherapy (HIPEC) during the course of cytoreductive surgery have been described, but no significant differences in treatment results have been found among them. HIPEC is a safe treatment for ... ...

Abstract	Several methods of delivering hyperthermic intraperitoneal chemotherapy (HIPEC) during the course of cytoreductive surgery have been described, but no significant differences in treatment results have been found among them. HIPEC is a safe treatment for the patient and for healthcare workers involved in the procedure provided standard protective and environmental measures are used. This article describes the different techniques in use and the technology available for the administration of HIPEC. Also reviewed are the safety features that must be taken into consideration when performing this procedure. Recommended guidelines to prevent associated occupational hazards are provided.
MeSH term(s)	Carcinoma/drug therapy ; Carcinoma/surgery ; Chemotherapy, Cancer, Regional Perfusion/adverse effects ; Chemotherapy, Cancer, Regional Perfusion/methods ; Humans ; Hyperthermia, Induced/methods ; Infusions, Parenteral/adverse effects ; Infusions, Parenteral/methods ; Peritoneal Neoplasms/drug therapy ; Peritoneal Neoplasms/surgery ; Safety
Language	English
Publishing date	2012-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1196919-2
ISSN	1558-5042 ; 1055-3207
ISSN (online)	1558-5042
ISSN	1055-3207
DOI	10.1016/j.soc.2012.07.001
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Article ; Online: Hyperthermic intraperitoneal chemotherapy: Rationale and technique.

González-Moreno, Santiago / González-Bayón, Luis A / Ortega-Pérez, Gloria

World journal of gastrointestinal oncology

2010 Volume 2, Issue 2, Page(s) 68–75

Abstract: The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms, either primary or secondary to ... ...

Abstract	The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms, either primary or secondary to digestive or gynecologic malignancy. Hyperthermic intraperitoneal chemotherapy (HIPEC) delivered in the operating room once the cytoreductive surgical procedure is finalized, constitutes the most common form of administration of perioperative intraperitoneal chemotherapy. This may be complemented in some instances with early postoperative intraperitoneal chemotherapy (EPIC). HIPEC combines the pharmacokinetic advantage inherent to the intracavitary delivery of certain cytotoxic drugs, which results in regional dose intensification, with the direct cytotoxic effect of hyperthermia. Hyperthermia exhibits a selective cell-killing effect in malignant cells by itself, potentiates the cytotoxic effect of certain chemotherapy agents and enhances the tissue penetration of the administered drug. The chemotherapeutic agents employed in HIPEC need to have a cell cycle nonspecific mechanism of action and should ideally show a heat-synergistic cytotoxic effect. Delivery of HIPEC requires an apparatus that heats and circulates the chemotherapeutic solution so that a stable temperature is maintained in the peritoneal cavity during the procedure. An open abdomen (Coliseum) or closed abdomen technique may be used, with no significant differences in efficacy proven to date. Specific technical training and a solid knowledge of regional chemotherapy management are required. Concerns about safety of the procedure for operating room personnel are expected but are manageable if universal precautions and standard chemotherapy handling procedures are used. Different HIPEC drug regimens and dosages are currently in use. A tendency for concurrent intravenous chemotherapy administration (bidirectional chemotherapy, so-called "HIPEC plus") has been observed in recent years, with the aim to further enhance the cytotoxic potential of HIPEC. Future trials to ascertain the ideal HIPEC regimen in different diseases and to evaluate the efficacy of new drugs or drug combinations in this context are warranted.
Language	English
Publishing date	2010-12-10
Publishing country	China
Document type	Journal Article
ZDB-ID	2573696-6
ISSN	1948-5204 ; 1948-5204
ISSN (online)	1948-5204
ISSN	1948-5204
DOI	10.4251/wjgo.v2.i2.68
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Article ; Online: GECOP-MMC: phase IV randomized clinical trial to evaluate the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) with mytomicin-C after complete surgical cytoreduction in patients with colon cancer peritoneal metastases.

Pereira, Fernando / Serrano, Angel / Manzanedo, Israel / Pérez-Viejo, Estibalitz / González-Moreno, Santiago / González-Bayón, Luis / Arjona-Sánchez, Alvaro / Torres, Juan / Ramos, Isabel / Barrios, Maria E / Cascales, Pedro / Morales, Rafael / Boldó, Enrique / García-Fadrique, Alfonso / Arteaga, Xabier / Gutierrez-Calvo, Alberto / Sánchez-García, Susana / Asensio, Enrique / Ramírez, Cesar P /

Artiles, Manuel / Vaqué, Javier / Parra, Pedro A / Villarejo, Pedro / Muñoz-Casares, Cristóbal / Turienzo, Estrella / Calero, Alicia / Torrejimeno, Isabel Jaén / Prieto, Isabel / Galindo, Julio / Borrego, Vicente / Marcello, Manuel E / Rihuete, Cristina / Carrasco, Joaquin / Gomez-Quiles, Luis

BMC cancer

2022 Volume 22, Issue 1, Page(s) 536

Abstract: Background: The French PRODIGE 7 trial, published on January 2021, has raised doubts about the specific survival benefit provided by HIPEC with oxaliplatin 460 mg/m: Methods: GECOP-MMC is a prospective, open-label, randomized, multicenter phase IV ... ...

Abstract	Background: The French PRODIGE 7 trial, published on January 2021, has raised doubts about the specific survival benefit provided by HIPEC with oxaliplatin 460 mg/m Methods: GECOP-MMC is a prospective, open-label, randomized, multicenter phase IV clinical trial that aims to evaluate the effectiveness of HIPEC with high-dose mytomicin-C in preventing the development of peritoneal recurrence in patients with limited peritoneal metastasis from colon cancer (not rectal), after complete surgical cytoreduction. This study will be performed in 31 Spanish HIPEC centres, starting in March 2022. Additional international recruiting centres are under consideration. Two hundred sixteen patients with PCI ≤ 20, in which complete cytoreduction (CCS 0) has been obtained, will be randomized intraoperatively to arm 1 (with HIPEC) or arm 2 (without HIPEC). We will stratified randomization by surgical PCI (1-10; 11-15; 16-20). Patients in both arms will be treated with personalized systemic chemotherapy. Primary endpoint is peritoneal recurrence-free survival at 3 years. An ancillary study will evaluate the correlation between surgical and pathological PCI, comparing their respective prognostic values. Discussion: HIPEC with high-dose mytomicin-C, in patients with limited (PCI ≤ 20) and completely resected (CCS 0) peritoneal metastases, is assumed to reduce the expected risk of peritoneal recurrence from 50 to 30% at 3 years. Trial registration: EudraCT number: 2019-004679-37; Clinicaltrials.gov: NCT05250648 (registration date 02/22/2022, ).
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Colonic Neoplasms/drug therapy ; Colonic Neoplasms/surgery ; Colorectal Neoplasms/pathology ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced/methods ; Hyperthermic Intraperitoneal Chemotherapy ; Mitomycin/therapeutic use ; Percutaneous Coronary Intervention ; Peritoneal Neoplasms/secondary ; Prospective Studies ; Rectal Neoplasms/therapy ; Survival Rate
Chemical Substances	Mitomycin (50SG953SK6)
Language	English
Publishing date	2022-05-12
Publishing country	England
Document type	Clinical Trial, Phase IV ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	2041352-X
ISSN	1471-2407 ; 1471-2407
ISSN (online)	1471-2407
ISSN	1471-2407
DOI	10.1186/s12885-022-09572-7
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Article ; Online: Single-Institution Multidisciplinary Management of Locoregional Oligo-Recurrent Pelvic Malignancies: Long-Term Outcome Analysis.

Sole, Claudio V / Calvo, Felipe A / Lizarraga, Santiago / Gonzalez-Bayon, Luis / Segundo, Carmen Gonzalez San / Desco, Manuel / García-Sabrido, Jose L

Annals of surgical oncology

2015 Volume 22 Suppl 3, Page(s) S1247–55

Abstract: Purpose: The aim of this study was to analyze long-term outcomes and prognostic factors associated with survival in patients with locoregional oligo-recurrent (LROR) pelvic malignancies treated in a multimodal protocol.: Methods: Patients with an ... ...

Abstract	Purpose: The aim of this study was to analyze long-term outcomes and prognostic factors associated with survival in patients with locoregional oligo-recurrent (LROR) pelvic malignancies treated in a multimodal protocol. Methods: Patients with an histologic diagnosis of LROR pelvic cancer (rectal 50 %, gynecological 50 %) with absence of distant metastases, undergoing surgery with radical intent and intraoperative radiotherapy (median dose 12.5 Gy) were considered eligible for participation in this study. Additionally, 48 % received external beam radiotherapy (EBRT) (median dose 50 Gy). Results: From 1995 to 2012, a total of 143 patients from a single institution were analyzed. With a median follow-up time of 48 months (range 2-189), 5-year locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) were 53, 44, and 46 %, respectively. On multivariate analysis, no EBRT treatment to the locoregional (p ≤ 0.001), R1 margin status (p = 0.03), time interval from primary tumor diagnosis to LROR <24 months (p = 0.05), and fragmentation in the resected specimen (p = 0.004) retained significance in relation to LRC. On multivariate analysis we found that only R1 margin status (p = 0.003), primary tumor diagnosis to LROR <24 months (p = 0.02), and high histological grade (p = 0.02) were significantly associated with OS. Conclusions: From this analysis emerges the fact that EBRT influences local control but, given the high risk of distant metastases, DFS remains modest. Margin status, tumor fragmentation, no EBRT to the LR, and time interval from primary tumor diagnosis to LROR are the dominant factors for subsequent locoregional recurrence (LRR). Accordingly, future prospective studies might be designed which adapt treatment according to the predicted risk of subsequent LRR.
MeSH term(s)	Adenocarcinoma/secondary ; Adenocarcinoma/therapy ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/secondary ; Carcinoma, Squamous Cell/therapy ; Combined Modality Therapy ; Disease Management ; Female ; Follow-Up Studies ; Genital Neoplasms, Female/pathology ; Genital Neoplasms, Female/therapy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Pelvic Neoplasms/secondary ; Pelvic Neoplasms/therapy ; Prognosis ; Prospective Studies ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Survival Rate
Language	English
Publishing date	2015-12
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-015-4604-2
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