Spread into Peritoneal

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Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Spread into Peritoneal

Postby Rock_Robster » Sat Sep 21, 2019 8:36 pm

nzjez wrote:
Rock_Robster wrote:One other comment on the PRODIGE 7 trial results - this trial used oxaliplatin as the HIPEC drug. I’ve seen inconsistent results between this and mitomycin-C (MMC), some research suggests Oxaliplatin has the edge, but some more recent studies indicate significantly better results from MMC. Might also be a topic for discussion with whomever is planning the surgery.


Hi Rob
Thanks for all your advice and input. I really appreciate everything you've said, and your though into it.
Definitely will chat about the type of HIPEC, and any reasoning the surgeon/ oncologist has as to their choice esp with recent study finding. Even whether HIPEC is recommend? Maybe CRS on its own to reduce morbidity?
The pelvic Exenteration surgery ive also been suggested does also sound like and option, but I'm really hoping they can make CRS a good feasible choice. PE sounds such a drastic terrible surgery.

No problem at all, sounds like you’re heading down the right path with regard to the conversations.

Just out of interest, am I right in assuming from your username you’re in NZ?

I agree re PE surgery - whilst these are all big procedures, this is another level again. I haven’t heard of PE used for peri mets so much; here it’s more used for complex local recurrence of rectal cancer that can’t be managed with a more localised resection. If they believe they can remove all macroscopic disease with CRS then I’m sure this would be preferable.

I’ve seen a few people here comment that if they had their time again they would do CRS without HIPEC. I can also understand that based on the research so far. I guess the question will be, given you’re having major surgery anyway, does adding HIPEC materially increase your risk of complications - and if not and may add a few % of survival benefit, then perhaps there’s an argument for it. Maybe others who’ve had this procedure can weigh in here.

Good luck, let us know how you go.

Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets, resectable
pT3pN1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response, TRG 3
07/19 - ULAR (robot), temp ileo, 1/27 LN
08/19 - Missed liver spot
08-11/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 5
12/19 - Planned liver resection #2 & stoma reversal

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