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The INDEPSO-ISPSM Consensus on Peritoneal Malignancies-Methodology.

Swapnil Patel1, Vivek Sukumar2, Somashekhar S P3

  • 1Department of Surgical Oncology, Upkar Hospital and Cancer Institute, Varanasi, India.

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Summary
This summary is machine-generated.

This study established consensus on cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies, addressing gaps in international guidelines. The findings offer a valuable clinical resource for surgeons in India and similar regions.

Keywords:
Cytoreductive surgeryDelphi techniquePeritoneal mesothelioma

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Area of Science:

  • Surgical Oncology
  • Peritoneal Malignancies
  • Evidence-Based Medicine

Background:

  • International guidelines for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have limitations regarding clinically relevant and regional issues.
  • There is a need for consensus on specific aspects of CRS and HIPEC, particularly in resource-limited settings and for specific patient populations.

Purpose of the Study:

  • To develop a consensus on cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies.
  • To address evidence gaps and regional considerations in CRS and HIPEC protocols.

Main Methods:

  • A modified Delphi technique involving two rounds of online voting.
  • A working group of 29 experts selected eight key topics.
  • A panel of 56 experienced oncologists voted on 260 closed-ended questions via SurveyMonkey.

Main Results:

  • A consensus was achieved on 80.7% of questions after two rounds, with a high participation rate (98.2% in round I, 94.6% in round II).
  • Consensus was highest in the enhanced recovery after surgery (ERAS) section (93.3%) and lowest for ovarian cancer (68.0%).
  • A strong consensus was reached on 22.6% of questions, with the technical section having the highest strong consensus rate (34.2%).

Conclusions:

  • The developed consensus provides a valuable clinical resource for surgeons managing peritoneal malignancies.
  • This consensus is particularly relevant for India and other regions with similar demographic and socioeconomic backgrounds.
  • The methodology and high participation rate ensure the robustness of the findings for guiding clinical practice.