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4. Cytoreductive surgery and HIPEC improve survival compared to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: A multi-institutional cohort from PSOGI and BIG RENAPE groups

Author

I. Amblard, F. Mercier, D.L. Bartlett, S.A. Ahrendt, K.W. Lee, H.J. Zeh, E.A. Levine, D. Baratti, M. Deraco, P. Piso, D.L. Morris, B. Rau, A.A.K. Tentes, J.-J. Tuech, F. Quenet, E. Akaishi, M. Pocard, Y. Yonemura, G. Lorimier, D. Delroeux, L. Villeneuve, O. Glehen, G. Passot, J. Abba, K. Abboud, M. Alyami, C. Arvieux, N. Bakrin, J.-M. Bereder, D. Bouzard, C. Brigand, S. Carrère, F. Dumont, C. Eveno, O. Facy, F. Guyon, R. Kianmanesh, R. Lo Dico, F. Marchal, P. Mariani, P. Meeus, S. Msika, P. Ortega-Deballon, B. Paquette, P. Peyrat, N. Pirro, J. Porcheron, P. Rat, O. Sgarbura, E. Thibaudeau, F. Zinzindohoue, S.H. Baik, A. Bhatt, P. Cachin, W. Ceelen, I. De Hingh, M. De Simone, P. Dubé, R.P. Edwards, J. Franko, L. Gonzalez-Bayon, V. Gushchin, M.P. Holtzman, M.-C. Hsieh, D. Kecmanovic, K. Lehmann, Y. Liu, S. Mehta, S. O'Dwyer, E. Orsevigo, P.K. Pande, E.J. Park, J.F. Pingpank, F. Rajan, A. Sardi, L. Sideris, A. Sommariva, J. Spiliotis, P. Sugarbaker, M. Teo, R. Yarema, R. Younan, S.S. Zaveri, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Chirurgie d'Oncologie Digestive [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)

Subjects
Adult, Male, medicine.medical_specialty, Peritoneal metastasis, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Klatskin, medicine, Humans, Prospective Studies, Registries, Peritoneal Neoplasms, Aged, Aged, 80 and over, Chemotherapy, business.industry, Gallbladder, Cytoreduction Surgical Procedures, Hyperthermia, Induced, General Medicine, Middle Aged, Hilar cholangiocarcinoma, Prognosis, Gemcitabine, 3. Good health, Surgery, Biliary carcinoma, Survival Rate, medicine.anatomical_structure, Bile Duct Neoplasms, Oncology, 030220 oncology & carcinogenesis, Cohort, Peritoneal Cancer Index, Intra-hepatic cholangiocarcinoma, Female, Hyperthermic intraperitoneal chemotherapy, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies, medicine.drug
Abstract

Background Peritoneal metastasis from biliary carcinoma (PMC) is associated with poor prognosis when treated with chemotherapy. Objective To evaluate the impact on survival of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and compare with conventional palliative chemotherapy for patients with PMC. Material and methods A prospective multicenter international database was retrospectively searched to identify all patients with PMC treated with a potentially curative CRS/HIPEC (CRS/HIPEC group). The overall survival (OS) was compared to patients with PMC treated with palliative chemotherapy (systemic chemotherapy group). Survival was analyzed using Kaplan-Meier method and compared with Log-Rank test. Results Between 1995 and 2015, 34 patients were included in the surgical group, and compared to 21 in the systemic chemotherapy group. In the surgical group, median peritoneal cancer index was 9 (range 3–26), macroscopically complete resection was obtained for 25 patients (73%). There was more gallbladder localization in the surgical group compared to the chemotherapy group (35% vs. 18%, p = 0.001). Median OS was 21.4 and 9.3 months for surgical and chemotherapy group, respectively (p=0.007). Three-year overall survival was 30% and 10% for surgical and chemotherapy group, respectively. Conclusion Treatment with CRS and HIPEC for biliary carcinoma with peritoneal metastasis is feasible and may provide survival benefit when compared to palliative chemotherapy.

Published
2018
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5. Is there an oncological interest in the combination of CRS/HIPEC for peritoneal carcinomatosis of HCC? Results of a multicenter international study

Author

Vadim Gushchin, M. Teo, Frédéric Dumont, David L. Morris, Jean-Jacques Tuech, Guillaume Passot, Lilian Schwarz, R. Kianmanesh, J. Abba, M. De Simone, Antonio Sommariva, D. Kecmanovic, Jan Franko, D. Delroeux, Rami Younan, S.S. Zaveri, Catherine Arvieux, G. Ferron, Olivier Glehen, Mao-Chih Hsieh, Marc Pocard, Frédéric Marchal, P.K. Pande, Gérard Lorimier, Beate Rau, M.-C. Hsieh, Cécile Brigand, F. Rajan, Seung Hyuk Baik, S. Carrère, P. Meeus, F. Guyon, N. Pirro, Y. Liu, P. Ortega-Deballon, Edward A. Levine, P. Piso, Dario Baratti, F. Zinzindohoue, E. Thibaudeau, A. Sardi, Diane Goéré, J.-M. Bereder, A.A.K. Tentes, R. Lo Dico, Mohammad Alyami, J. Porcheron, O. Sgarbura, S. Mehta, L. Gonzalez-Bayon, Aditi Bhatt, M.P. Holtzman, Pascale Mariani, Wim Ceelen, S.A. Ahrendt, K. Abboud, O. Facy, E. Orsenigo, David L. Bartlett, Paul H. Sugarbaker, P. Cachin, N. Bakrin, Laurent Villeneuve, R.P. Edwards, B. Paquette, J.F. Pingpank, P. Rat, K. Lehmann, Y. Yonemura, S. O'Dwyer, P. Peyrat, John Spiliotis, D. Bouzard, Sanket Mehta, K.W. Lee, I. H. J. T. de Hingh, François Quenet, L. Sideris, S. Msika, Roman Yarema, Eduardo Hiroshi Akaishi, Clarisse Eveno, H.J. Zeh, Pierre Dubé, Eun Jung Park, Vahan Kepenekian, Département de chirurgie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut Gustave Roussy (IGR), Département de chirurgie, CRLCC Val d'Aurelle - Paul Lamarque, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), and Hospices Civils de Lyon (HCL)

Subjects
Male, MESH: Combined Modality Therapy, Colorectal cancer, Hepatocellular carcinoma, 0302 clinical medicine, MESH: Liver Neoplasms, Pseudomyxoma peritonei, MESH: Peritoneal Neoplasms, Cytoreductive surgery, MESH: Carcinoma, Hepatocellular, Peritoneal Neoplasms, MESH: Treatment Outcome, MESH: Aged, Univariate analysis, MESH: Middle Aged, Standard treatment, Liver Neoplasms, General Medicine, Cytoreduction Surgical Procedures, Middle Aged, Prognosis, Combined Modality Therapy, 3. Good health, Survival Rate, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Hyperthermic intraperitoneal chemotherapy, Female, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, MESH: Survival Rate, Adolescent, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, 03 medical and health sciences, medicine, Humans, MESH: Cytoreduction Surgical Procedures, MESH: Hyperthermia, Induced, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, HIPEC, business.industry, MESH: Adult, MESH: Retrospective Studies, Hyperthermia, Induced, medicine.disease, MESH: Male, Surgery, Peritoneal Cancer Index, Ovarian cancer, business, MESH: Female, Peritoneal carcinomatosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction Peritoneal metastasis (PM) of hepatocellular carcinoma (HCC) without distant spread are rare. The related prognosis is poor without standard treatment available. The role of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is poorly documented. Methods An international multicentric cohort was constituted by retrospective analysis of 21 patients undergoing CRS/HIPEC for PM of HCC between 1992 and 2016 from 10 reference centers of PSOGI. Data on clinical features, treatment strategies, and survival outcomes were analyzed. Results The median time interval from the diagnosis of PM to the procedure was 4.5 months. The median peritoneal cancer index was 14. Sixteen patients had complete cytoreduction (CCR0-1). Ten patients had grades 3 to 4 complications. The median duration of follow-up was 52.2 months. The median OS was 46.7 months. The projected 3y-OS and 5y-OS were 88.9 and 49.4% respectively. The median OS for patients with CCR0-1 resection was not reached whereas it was 5.9 months for those with CCR2-3 resection after CRS (p = 0.0005). The median RFS was 26.3 months and projected RFS at 3 years of 36.5 months Three prognostic factors were associated with improved RFS in the univariate analysis: preoperative chemotherapy (p = 0.0156), PCI >15 (p = 0.009), Number of chemotherapy agents used for HIPEC (p = 0.005). Conclusion CRS/HIPEC is a safe and effective approach in selected patients with PM of HCC. CRS/HIPEC gives the patient a chance for a good relapse free and overall survival and should be considered as an option.

Published
2018
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7. Villoglandular adenocarcinoma of the cervix recurrent in an episiotomy scar: a case report in a 32-year-old female

Author

R.P Edwards, Kristina Gerszten, John T. Comerci, Joseph L. Kelley, Dwight E. Heron, A. Axtel, and A. Amortegui

Subjects
Adult, Episiotomy, medicine.medical_specialty, medicine.medical_treatment, Uterine Cervical Neoplasms, Adenocarcinoma, Perineum, Villoglandular adenocarcinoma of the cervix, Pregnancy, medicine, Humans, Radical Hysterectomy, Cervix, Cervical cancer, business.industry, Wide local excision, Obstetrics and Gynecology, medicine.disease, Neoadjuvant Therapy, Surgery, medicine.anatomical_structure, Oncology, Female, Lymphadenectomy, Neoplasm Recurrence, Local, business, Pregnancy Complications, Neoplastic, Anterior lip
Abstract

Cervical cancer during pregnancy is rare, occurring in approximately 3% of cervical cancer cases. Considerable controversy exists as to the long-term prognosis of patients diagnosed during pregnancy. A 32-year-old female presented with vaginal spotting in April 1998. A prenatal smear in December 1996 revealed atypical glandular cells of undetermined significance. A sterile speculum exam in April 1997 at 31-week gestational age revealed a polyp on the anterior lip of the cervix, pathology consistent with a well-differentiated villoglandular adenocarcinoma. In August 1997, the patient underwent a radical hysterectomy with pelvic/para-aortic lymphadenectomy. In April 2001, she represented with nodular perineal mass in the episiotomy incision. She received preoperative radiotherapy with a near-complete response and remained without disease for >10 months. It appears that a less radical procedure can offer significant therapeutic value. Preoperative radiotherapy proved effective at achieving a near-complete response. The patient underwent a wide local excision of the perineal area with resultant negative margins

Published
2005
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10. HDR Interstitial CT based Brachytherapy For the Treatment of Cervical Cancer: Early Results

Author

N. Kannan, S. Beriwal, H. Kim, C. Houser, R. Mogus, P. Sukumvanich, A.B. Olawaiye, S. Richard, J.L. Kelley, and R.P. Edwards

Subjects
Cervical cancer, Cancer Research, medicine.medical_specialty, Radiation, business.industry, medicine.medical_treatment, Brachytherapy, medicine.disease, Oncology, Early results, Medicine, Radiology, Nuclear Medicine and imaging, Radiology, business
Published
2011
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11. Mineralization in the British Isles

Author

R.P. Edwards

Subjects
Mineralization (geology), Control and Systems Engineering, Mechanical Engineering, General Chemistry, Geotechnical Engineering and Engineering Geology, Archaeology, Geology
Published
1994
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13. Enhanced endocytosis by aging chondrocytes and fibroblasts

Author

Christopher H. Evans, R.P. Edwards, and Helga I. Georgescu

Subjects
Cartilage, Articular, Aging, Time Factors, Endocytosis, Biochemistry, Chondrocyte, Endocrinology, Genetics, medicine, Animals, Humans, Fibroblast, Molecular Biology, Cells, Cultured, Latex beads, Lagomorpha, biology, Cell Biology, Fibroblasts, biology.organism_classification, Cell biology, Rats, medicine.anatomical_structure, Cell culture, Ageing, Immunology, Rabbits
Abstract

We have compared the uptake of latex beads by cultures of old and young chondrocytes and fibroblasts. In each case, their phagocytic rates increased with cellular age.

Published
1984

14. Content-addressable distributed-logic memories

Author

R.P. Edwards

Subjects
Physics, symbols.namesake, business.industry, Content (measure theory), Electronic engineering, symbols, Electrical engineering, Electrical and Electronic Engineering, Distributed logic, business, Gaussian process, Current density, Voltage
Published
1964
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