Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun;157(3S1):S25-S31.
doi: 10.1016/j.jviscsurg.2020.04.013. Epub 2020 Apr 23.

Treatment of primary and metastatic peritoneal tumors in the Covid-19 pandemic. Proposals for prioritization from the RENAPE and BIG-RENAPE groups

O Glehen  1 , V Kepenekian  2 , O Bouché  3 , L Gladieff  4 , C Honore  5 ; RENAPE-BIG-RENAPE
Collaborators, Affiliations
Review

Treatment of primary and metastatic peritoneal tumors in the Covid-19 pandemic. Proposals for prioritization from the RENAPE and BIG-RENAPE groups

O Glehen et al. J Visc Surg. 2020 Jun.

Abstract

The Covid-19 pandemic is profoundly changing the organization of healthcare access. This is particularly so for peritoneal neoplastic diseases, for which curative treatment mobilizes substantial personnel, operating room and intensive care resources. The BIG-RENAPE and RENAPE groups have made tentative proposals for prioritizing care provision. A tightening of the usual selection criteria is needed for curative care: young patients with few or no comorbidities and limited peritoneal extension. It is desirable to prioritize disease conditions for which cytoreduction surgery with or without associated hyperthermic intraoperative peritoneal chemotherapy (HIPEC) is the gold-standard treatment, and for which systemic chemotherapy cannot be a temporary or long-term alternative: pseudomyxoma peritonei, resectable malignant peritoneal mesotheliomas, peritoneal metastases of colorectal origin if they are resectable and unresponsive to systemic chemotherapy after up to 12 courses, first-line ovarian carcinomatosis if resectable or in interval surgery after at most six courses of systemic chemotherapy. Addition of HIPEC must be discussed case by case in an expert center. The prioritization of indications must consider local conditions and the phase of the epidemic to allow optimal peri-operative care.

Keywords: Coronavirus; Covid-19; Peritoneal metastases; Primary peritoneal tumor.

PubMed Disclaimer

References

    1. Passot G., Vaudoyer D., Villeneuve L. A perioperative clinical pathway can dramatically reduce failure-to-rescue rates after cytoreductive surgery for peritoneal carcinomatosis: a retrospective study of 666 consecutive cytoreductions. Ann Surg. 2017;265(4):806–813. - PubMed
    1. Cortes-Guiral D., Mohamed F., Glehen O., Passot G. Prehabilitation of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancy. Eur J Surg Oncol. 2020 - PubMed
    1. Di Fiore F., Bouché O., Lepage C. COVID-19 epidemic: proposed alternatives in the management of digestive cancers: a French Intergroup clinical point of view (TNCD) Dig Liver Dis. 2020 - PMC - PubMed
    1. Dohan A., Hoeffel C., Soyer P. Evaluation of the peritoneal carcinomatosis index with CT and MRI. Br J Surg. 2017;104(9):1244–1249. - PubMed
    1. Low R.N., Barone R.M., Rousset P. Peritoneal MRI in patients undergoing cytoreductive surgery and HIPEC: history, clinical applications, and implementation. Eur J Surg Oncol. 2019 - PubMed