Souadka Amine, Essangri Hajar, Makni Amin, Abid Mourad, Ayadi Mouna, Ksantini Feriel, Kordjani Zakia, Ballah Yousri, Bouka Jemila, Benkabbou Amine, Majbar Mohammed Anass, El Khannoussi Basma, Mohsine Raouf, Boutayeb Saber, Hubner Martin
Surgical Oncology Department, National Institute of Oncology, University Mohammed V, Rabat, Morocco.
Surgical Department A, Rabta Hospital, Tunis, Tunisia.
Front Surg. 2022 Mar 8;9:798523. doi: 10.3389/fsurg.2022.798523. eCollection 2022.
The status of peritoneal surface malignancy (PSM) management in North Africa is undetermined. The aim of this study was to assess and compare current practice and knowledge regarding PSM and examine satisfaction with available treatment options and need for alternative therapies in North Africa.
This is a qualitative study involving specialists participating in PSM management in North Africa. The survey analyzed demographic characteristics and current knowledge and opinions regarding PSM management in different institutions. We also looked at goals and priorities, satisfaction with treatment modalities and heated intraperitoneal chemotherapy (HIPEC) usefulness according to specialty, country, years of experience, and activity sector.
One-hundred and three participants responded to the survey (response rate of 57%), including oncologists and surgeons. 59.2% of respondents had more than 10 years experience and 45.6% treated 20-50 PSM cases annually. Participants satisfaction with PSM treatment modalities was mild for gastric cancer (3/10 [IQR 2-3]) and moderate for colorectal (5/10 [IQR 3-5]), ovarian (5/10 [IQR 3-5]), and pseudomyxoma peritonei (5/10 [IQR 3-5]) type of malignancies. Good quality of life and symptom relief were rated as main priorities for treatment and the need for new treatment modalities was rated 9/10 [IQR 8-9]. The perceived usefulness of systemic chemotherapy in first intention was described as high by 42.7 and 39.8% of respondents for PSM of colorectal and gastric origins, while HIPEC was described as highly useful for ovarian (49.5%) and PMP (73.8) malignancies.
The management of PSM in the North African region has distinct differences in knowledge, treatments availability and priorities. Disparities are also noted according to specialty, country, years of expertise, and activity sector. The creation of referral structures and PSM networks could be a step forward to standardized PSM management in the region.
北非腹膜表面恶性肿瘤（PSM）的管理现状尚不确定。本研究的目的是评估和比较关于PSM的当前实践和知识，并考察北非对现有治疗方案的满意度以及对替代疗法的需求。
这是一项定性研究，涉及参与北非PSM管理的专家。该调查分析了人口统计学特征以及不同机构中关于PSM管理的当前知识和观点。我们还根据专业、国家、经验年限和活动领域，研究了目标和优先事项、对治疗方式的满意度以及热灌注化疗（HIPEC）的有用性。
103名参与者回复了调查（回复率为57%），包括肿瘤学家和外科医生。59.2%的受访者有超过10年的经验，45.6%的受访者每年治疗20 - 50例PSM病例。参与者对胃癌PSM治疗方式的满意度为轻度（3/10[四分位距2 - 3]），对结直肠癌、卵巢癌和腹膜假黏液瘤PSM治疗方式的满意度为中度（5/10[四分位距3 - 5]）。良好的生活质量和症状缓解被评为治疗的主要优先事项，对新治疗方式的需求评分为9/10[四分位距8 - 9]。42.7%和39.8%的受访者认为一线全身化疗对结直肠癌和胃癌起源的PSM非常有用，而HIPEC对卵巢癌（49.5%）和腹膜假黏液瘤（73.8%）恶性肿瘤非常有用。
北非地区PSM的管理在知识、治疗可及性和优先事项方面存在明显差异。在专业、国家、专业年限和活动领域方面也存在差异。建立转诊结构和PSM网络可能是该地区实现PSM管理标准化的一个进步。
