Patel Swapnil, Sukumar Vivek, P Somashekhar S, Bhandoria Geetu, Chatterjee Ambarish, Deo Suryanarayana V S, Garach Niharika, Guru Arvind, Kumar Neha, Kumar Rohit, Rajagopal Ashwin K, Kumar Sanjeev, Mehta Sanket, Mishra Deepti, Pawar Ajinkya, Prabhu Aruna, Sinukumar Snita, Solanki Sohan, Sharma Vivekanand, Sheshadri Ramakrishnan Ayaloor, Bhatt Aditi
Department of Surgical Oncology, Upkar Hospital and Cancer Institute, Varanasi, India.
Department of Surgical Oncology, Specialty Surgical Oncology, Mumbai, India.
Indian J Surg Oncol. 2025 Apr;16(2):651-659. doi: 10.1007/s13193-024-02118-2. Epub 2024 Oct 28.
The numerous international guidelines on cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) do not cover many clinically relevant issues for which evidence is limited and some regional issues (HIPEC in limited resource settings, age-limit for CRS, etc.). We describe the methodology of a consensus CRS and HIPEC for peritoneal malignancies carried out under the aegis of the two national societies for peritoneal oncology-INDEPSO and ISPSM. The modified Delphi technique was used with two rounds of voting. Eight key topics were selected by a working group of 29 members. Questionnaires comprising of closed-ended questions were disseminated through the online SurveyMonkey (http://www.surveymonkey.com) platform. A panel of 56 surgical, gastrointestinal, and gynecologic oncologists with a minimum of 5 years of experience with CRS-HIPEC voted on 260 questions. A consensus was reached if any of the options received 70% or more votes (> 90% = strong consensus). The response rate was 98.2% in round I and 94.6% in round II. A consensus was achieved on 80.7% questions after two rounds (43.0% after round I; 36.9% after round II). It was the highest in the enhanced recovery after surgery (ERAS) section (93.3%) and the lowest (68.0%) for ovarian cancer. A strong consensus was reached on 59 (22.6%) questions (highest for the technical section (34.2%); lowest in the ERAS section (16.6%)). This consensus which had a high rate of participation should be a useful clinical resource for surgeons treating peritoneal malignancies in India and other regions with a similar demographic and socioeconomic background.
The online version contains supplementary material available at 10.1007/s13193-024-02118-2.
众多关于减瘤手术(CRS)和热灌注化疗(HIPEC)的国际指南并未涵盖许多临床相关问题,这些问题的证据有限,还包括一些地区性问题(资源有限环境下的HIPEC、CRS的年龄限制等)。我们描述了在两个国家腹膜肿瘤学会——印度腹膜肿瘤学会(INDEPSO)和印度腹膜表面肿瘤外科学会(ISPSM)的支持下,针对腹膜恶性肿瘤开展的CRS和HIPEC共识制定方法。采用了改良德尔菲技术进行两轮投票。由29名成员组成的工作组选定了八个关键主题。包含封闭式问题的问卷通过在线SurveyMonkey(http://www.surveymonkey.com)平台分发。由56名具有至少5年CRS - HIPEC经验的外科、胃肠和妇科肿瘤学家组成的小组对260个问题进行了投票。如果任何一个选项获得70%或更多选票(> 90% = 强烈共识),则达成共识。第一轮的回复率为98.2%,第二轮为94.6%。两轮后,80.7%的问题达成了共识(第一轮后为43.0%;第二轮后为36.9%)。在术后加速康复(ERAS)部分达成的共识最高(93.3%),而卵巢癌部分最低(68.0%)。59个(22.6%)问题达成了强烈共识(技术部分最高,为34.2%;ERAS部分最低,为16.6%)。这种参与率很高的共识对于在印度以及其他具有相似人口统计学和社会经济背景的地区治疗腹膜恶性肿瘤的外科医生来说,应该是一种有用的临床资源。
在线版本包含可在10.1007/s13193 - 024 - 02118 - 2获取的补充材料。