AIHTA - Publications - Search - Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for secondary peritoneal carcinomatosis: 1st Update

Auinger, D. (2022): Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for secondary peritoneal carcinomatosis: 1st Update. Decision Support Document 74/ Update 2022.

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In 2014, the Ludwig Boltzmann Institute for Health Technology Assessment carried out an evidence analysis for the decision support document on the intervention "cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC)" in secondary peritoneal carcinosis of colorectal, gastric, and ovarian cancer. At the time, the inclusion of the intervention in the service catalogue was not recommended.

One new clinical study was identified for the indication of colorectal cancer. This study shows a slightly longer, but statistically non-significant overall and disease-free survival time in the intervention group. One new study was also included for the indication gastric carcinoma. However, it only included 17 study participants, which meant that no statistical analyses were possible. Four new studies were available for the indication ovarian cancer. These had similar inclusion criteria and treatment regimens. Although some of the studies showed an advantage in overall and disease-free survival, this was not confirmed in the others. The confidence in the measured effects is low to very low for all indications, either due to a low number of participants and/or various potential biases (e.g. non-blinding of the outcome assessor, obsolete comparative intervention). In terms of safety, the intervention tended to be less safe than standard therapy in terms of postoperative mortality in the trials. With regard to perioperative morbidity, it is unclear which procedure brings with it fewer complications, due to the inconsistency of the results.

The evidence for all three indications could be expanded by a total of six randomised controlled trials - four of them for the first time on ovarian cancer. The confidence in the reported effects is clearly limited for all parameters. A limitation of this report is that no four-eye principle was used for the analysis, as this is a Master's thesis that has to be carried out individually. Overall, on the basis of the current study situation, an inclusion of the intervention in the service catalogue is still not recommended for any of the indications analysed. Further clinical studies are still underway, which may lead to a different conclusion in the future.

Item Type:Decision Support Document
Keywords:Cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, secondary peritoneal carcinomatosis, CRS, HIPEC
Subjects:QZ Pathology > QZ 200-380 Neoplasms.Cysts
W Health professions > W 100-275 Medical, dental and pharmaceutical service plans
WB Practice of medicine > WB 300-962 Therapeutics
WI Digestive system > WI 300-387 Stomach
WI Digestive system > WI 400-560 Intestines
WI Digestive system > WI 900-970 Abdomen
WO Surgery > WO 500-517 Operative surgical procedures. Techniques
WP Gynaecology > WP 440-468 Uterine diseases
Series Name:Decision Support Document 74/ Update 2022
Deposited on:23 Nov 2022 10:41
Last Modified:23 Nov 2022 10:41

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