HIPEC question
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Scaredoutofmind
- Posts: 60
- Joined: Fri Mar 13, 2015 7:24 pm
- Facebook Username: Ilene Mastrangelo
HIPEC question
For those who have had HIPEC did you also have a laparoscopic exam prior to becoming a HIPEC candidate? I wasn't sure if this is common or if the surgeons go off of scans.
Re: HIPEC question
My surgeon went off of scans, no laparoscopic procedure in advance.
Robin
Robin
Dx stage 4 Sept 2014 (MSS, KRAS Mutant)
Resection with peri mets identified visually during surgery
Nothing visible on CT
12 rounds FOLFOX w/ Avastin Nov - Apr 2015
Still nothing visible on CTs
HIPEC May 2015
7/2015 - 5 new spots on CT, PET confirmed 3 mets
8/12/15-Begin 12 rounds FOLFIRI
10/21/15 Scan - peri mets stable, 1 liver stable and 1 growing
12/4/15 - RFA of liver met
2/24/16 - scan was stable/shrinking moving to Xeloda/Avastin
Resection with peri mets identified visually during surgery
Nothing visible on CT
12 rounds FOLFOX w/ Avastin Nov - Apr 2015
Still nothing visible on CTs
HIPEC May 2015
7/2015 - 5 new spots on CT, PET confirmed 3 mets
8/12/15-Begin 12 rounds FOLFIRI
10/21/15 Scan - peri mets stable, 1 liver stable and 1 growing
12/4/15 - RFA of liver met
2/24/16 - scan was stable/shrinking moving to Xeloda/Avastin
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Steph20021
- Posts: 553
- Joined: Sat Dec 27, 2014 4:58 pm
- Location: Ontario, Canada
Re: HIPEC question
I did but it didn't show anything and due to the scar tissue I had it wasn't a very good look.
DX 1/31/14 @ 33- SPS-T4a(invades visceral peri), N2a(6/106 LN), M1a(ovary) (Stage 4a) MSS; BRAF V600E
2/1/14-subtotal col, lost R ovary, temp ileo
3/14-9/14- folfox; sepsis
11/14-CT/PET: L ovary met, pelvic met, (?)ghost liver met(?)
12/14-folfiri -13 rds kept me stable from 3/15-6/15
8/15-HIPEC, NED
09/15- cea 0.9
05/16- recurrence in abdo wall and lymph nodes
01/17- pulmonary embolism
02/17- 1 wk radiation to abdo wall
08/16- on folfiri
01/18-folfox
11/18- Beacon trial-encorafenib & cetuximab
2/1/14-subtotal col, lost R ovary, temp ileo
3/14-9/14- folfox; sepsis
11/14-CT/PET: L ovary met, pelvic met, (?)ghost liver met(?)
12/14-folfiri -13 rds kept me stable from 3/15-6/15
8/15-HIPEC, NED
09/15- cea 0.9
05/16- recurrence in abdo wall and lymph nodes
01/17- pulmonary embolism
02/17- 1 wk radiation to abdo wall
08/16- on folfiri
01/18-folfox
11/18- Beacon trial-encorafenib & cetuximab
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H is for Hawk
- Posts: 103
- Joined: Wed May 20, 2015 4:51 pm
- Location: eastern Pennsylvania
Re: HIPEC question
No laparoscopic exam in advance, but I did have a needle biopsy and PET scan to confirm reoccurance.
H is for Hawk (57)
10/14 L. hemi-colectomy 3 x 4 x 1 cm tumor, 13/14 lymph nodes pos. pT4a N2B M0 stage 3 MSS
11/14 - 4/15 12x FOLFOX
5/15 PET scan: 2.5 x 1.5 cm l. colon lesion, peri surface lesion SUV 2.4, adenocar., KRAS wd, BRAF V600E mut
6/15 HIPEC
9/15 Pleural lining & liver mets, CA 19-9: 6000
10/15 Vectibix Tafinlar Mekinist
11/15 1500
1/16 200
2/16 100, add Lentinan
3/16 122
6/16 4500
7/16 20,000, CT scan - three new liver mets
8/16 6700, FOLFIRI
9/16 4900, CT scan - two new liver mets
10/16 2255 vinorelbine
10/14 L. hemi-colectomy 3 x 4 x 1 cm tumor, 13/14 lymph nodes pos. pT4a N2B M0 stage 3 MSS
11/14 - 4/15 12x FOLFOX
5/15 PET scan: 2.5 x 1.5 cm l. colon lesion, peri surface lesion SUV 2.4, adenocar., KRAS wd, BRAF V600E mut
6/15 HIPEC
9/15 Pleural lining & liver mets, CA 19-9: 6000
10/15 Vectibix Tafinlar Mekinist
11/15 1500
1/16 200
2/16 100, add Lentinan
3/16 122
6/16 4500
7/16 20,000, CT scan - three new liver mets
8/16 6700, FOLFIRI
9/16 4900, CT scan - two new liver mets
10/16 2255 vinorelbine
Re: HIPEC question
No laparoscopic exam for me either. However, in The Netherlands and Belgium you only qualify for HIPEC in case CT's show no mets in lung and/or liver. Thankfully this policy is currently somewhat easing. For instance for patients with limited peritonial mets and a limited number of liver mets that are expected to respond well to treatment.
After the laparoscopic removal of a T4 CRC in the sigmoid, one tiny met was identified by the pathologist. During the HIPEC three more mets got removed, none visible on pre-op MRI and CT's.
After the laparoscopic removal of a T4 CRC in the sigmoid, one tiny met was identified by the pathologist. During the HIPEC three more mets got removed, none visible on pre-op MRI and CT's.
dx at 42yrs, kids 6 and 3, married.
07/15 SR CRC T4,N2,M1 (peritoneum), 8/39, CEA 1.4
09/15 CEA 3 start Sandwich procedure Capox 4rnds around HIPEC
10/15 CEA 5 . Abnormal nodes lungs. Laesies in liver, too small to be identified so cleared for HIPEC
12/15 Hipec 3 tiny -yet alive- mets removed (Douglas pouch). Unexpected LAMN tumor appendix resected. Colostomy, 2nd resc. of sigmoid 0/19.
01/16 CapOx 3x, 1x Mono Cap
05/16 CT: NED CEA 2
08/16 CEA 1
11/16 CT: NED , CEA 1
06/18 NED, CEA <1, CA19-9 7
07/15 SR CRC T4,N2,M1 (peritoneum), 8/39, CEA 1.4
09/15 CEA 3 start Sandwich procedure Capox 4rnds around HIPEC
10/15 CEA 5 . Abnormal nodes lungs. Laesies in liver, too small to be identified so cleared for HIPEC
12/15 Hipec 3 tiny -yet alive- mets removed (Douglas pouch). Unexpected LAMN tumor appendix resected. Colostomy, 2nd resc. of sigmoid 0/19.
01/16 CapOx 3x, 1x Mono Cap
05/16 CT: NED CEA 2
08/16 CEA 1
11/16 CT: NED , CEA 1
06/18 NED, CEA <1, CA19-9 7
Re: HIPEC question
No laparoscopy before HIPEC here either, just PET and CT scans.
Mom of 2-yr-old diagnosed at age 35. BRAF-V600E mutant, KRAS wild, MSS.
April 2015: laparoscopic extended right hemicolectomy, 85 nodes clear but T4 tumor depth: stage IIB.
June-Sept: adjuvant Xeloda, NED
Sept 2015: CEA rising, peritoneal mets: stage IV
Oct-Dec: FOLFOXIRI, 4 rounds
Jan 2016: HIPEC surgery with hysterectomy. PCI 8, complete cytoreduction.
Feb-July: NED again. 3 rounds XELOX, 3 rounds Avastin & Xeloda
July: Peritoneal recurrence, researching all options.
April 2015: laparoscopic extended right hemicolectomy, 85 nodes clear but T4 tumor depth: stage IIB.
June-Sept: adjuvant Xeloda, NED
Sept 2015: CEA rising, peritoneal mets: stage IV
Oct-Dec: FOLFOXIRI, 4 rounds
Jan 2016: HIPEC surgery with hysterectomy. PCI 8, complete cytoreduction.
Feb-July: NED again. 3 rounds XELOX, 3 rounds Avastin & Xeloda
July: Peritoneal recurrence, researching all options.
Re: HIPEC question
Hi
I had a laparoscopy before my HIPEC. I was told I only had two small spots on the lining of my peritoneum and a port site met (which had already been identified under biopsy). When I came round from the op they said they'd found an abundance of tumour covering most of my small bowel and with substantial vascular involvement. They also found that my initial anastomosis had regrown new tumour so needed to be excised and re-done. As a result the operation lasted 9 hours and they kept me under general for 24 hours.
All of which to say ... Approach this operation with a healthy skepticism regarding pre-op imaging. They only really know what's there once they go in. Also, recovery is quite brutal and can take months. My surgeon told me to get as cardio-fit as possible beforehand (walk, run, bike, whatever). It was incredibly sound advice in my case.
Good luck.
Tim
I had a laparoscopy before my HIPEC. I was told I only had two small spots on the lining of my peritoneum and a port site met (which had already been identified under biopsy). When I came round from the op they said they'd found an abundance of tumour covering most of my small bowel and with substantial vascular involvement. They also found that my initial anastomosis had regrown new tumour so needed to be excised and re-done. As a result the operation lasted 9 hours and they kept me under general for 24 hours.
All of which to say ... Approach this operation with a healthy skepticism regarding pre-op imaging. They only really know what's there once they go in. Also, recovery is quite brutal and can take months. My surgeon told me to get as cardio-fit as possible beforehand (walk, run, bike, whatever). It was incredibly sound advice in my case.
Good luck.
Tim
https://youtu.be/qoQbY4A5RNA
05/15 L hemi-colectomy
05/15 Dx st 3 T4N2M0 @43
kids: now 13, 10
BRAFm mucinous - KRASw
06/15 liver mets
06/15 CEA 9, CA19-9 400+
06/15 - 09/15 6 x FOLFOXIRI+Avastin
09/15 markers 4/50
10/15 drain-site met
11/15 CRS+HIPEC
1-8/16 BRAF triplet (dabrafenib, panitumumab, trametinib)
CEA;CA19-9: range 16;650 to 1;36 back to 4;135
8/16 progression
10/16-6/18 : NCT02650713
7/18-9/18 : anti-GITR; ERK inhib
10/18-4/19: folfoxiri+avastin
7/19-9/19 enco+cetux+Bini
10-19 starting regonivo
05/15 L hemi-colectomy
05/15 Dx st 3 T4N2M0 @43
kids: now 13, 10
BRAFm mucinous - KRASw
06/15 liver mets
06/15 CEA 9, CA19-9 400+
06/15 - 09/15 6 x FOLFOXIRI+Avastin
09/15 markers 4/50
10/15 drain-site met
11/15 CRS+HIPEC
1-8/16 BRAF triplet (dabrafenib, panitumumab, trametinib)
CEA;CA19-9: range 16;650 to 1;36 back to 4;135
8/16 progression
10/16-6/18 : NCT02650713
7/18-9/18 : anti-GITR; ERK inhib
10/18-4/19: folfoxiri+avastin
7/19-9/19 enco+cetux+Bini
10-19 starting regonivo
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