title: Cytoreductive surgery and HIPEC in treatment of colorectal peritoneal carcinomatosis: experiment or standard care? A survey among oncologic surgeons and medical oncologists.
abstract: BACKGROUND
  Controversy still exists regarding the position of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastasis of colorectal carcinoma. The goal of the current study was to evaluate the opinions about this treatment among Dutch oncologic surgeons and medical oncologists.
  
  
  METHODS
  An online survey was sent to all known Dutch oncologic surgeons (n = 459) and medical oncologists (n = 363) representing the respective departments of 84 hospitals. A comparison was made between surgeons and oncologists.
  
  
  RESULTS
  185 eligible responses were received from 71 hospitals, resulting in a response rate of 23 % for individuals and a response rate of 85 % for hospitals. Overall, 65 % of respondents regarded CRS+HIPEC as effective with sufficient evidence, 29 % responded that CRS+HIPEC is probably effective without sufficient evidence, and 7 % of respondents regards HIPEC as probably ineffective. Medical oncologists were less convinced of the effectiveness of CRS+HIPEC than surgeons (P = 0.006). Of all the respondents, 68 % indicated that they regard CRS+HIPEC as a standard treatment for patients with peritoneal dissemination of colorectal carcinoma (77 % of surgeons vs 54 % of oncologists, P = 0.001). Additionally, 68 % of respondents regard CRS+HIPEC as potentially curative (77 % of surgeons vs 54 % of oncologists, P = 0.001).
  
  
  CONCLUSIONS
  Approximately 30 % of physicians who treat colorectal carcinoma do not regard CRS+HIPEC as standard care. Surgeons appear to be significantly more in favor of this treatment than medical oncologists. This study shows that efforts should be made to improve knowledge and increase acceptance of CRS and HIPEC in colorectal cancer treatment among medical oncologists and surgeons.
authors: Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435 CM, The Netherlands. h.braam@antoniusziekenhuis.nl.
authors: Hidde J
authors: HJ
authors: Braam
authors: Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435 CM, The Netherlands.
authors: Djamila
authors: D
authors: Boerma
authors: Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435 CM, The Netherlands.
authors: Marinus J
authors: MJ
authors: Wiezer
authors: Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435 CM, The Netherlands.
authors: Bert
authors: B
authors: van Ramshorst
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures; D013502:General Surgery; D019538:Health Care Surveys; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D008495:Medical Oncology; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; Colorectal neoplasms; Medical oncology; Peritoneal neoplasms; Questionnaires; Surgery