Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial

M. P. Engbersen; C. J. Rijsemus; J. Nederend; A. G. J. Aalbers; I. H. J. T. de Hingh; null Retel; D. M. J. Lambregts; E. J. R. J. Van der Hoeven; D. Boerma; M. J. Wiezer; M. De Vries; E. V. E. Madsen; A. R. M. Brandt-Kerkhof; S. Van Koeverden; P. R. De Reuver; R. G. H. Beets-Tan; N. F. M. Kok; M. J. Lahaye

doi:10.1186/s12885-021-08168-x

Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial

M. P. Engbersen^*, C. J. Rijsemus, J. Nederend, A. G. J. Aalbers, I. H. J. T. de Hingh, Retel, D. M. J. Lambregts, E. J. R. J. Van der Hoeven, D. Boerma, M. J. Wiezer, M. De Vries, E. V. E. Madsen, A. R. M. Brandt-Kerkhof, S. Van Koeverden, P. R. De Reuver, R. G. H. Beets-Tan, N. F. M. Kok, M. J. Lahaye

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BackgroundSelecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging.MethodsThe study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI>24) or explorative surgeries in patients with limited disease (PCI

Original language	English
Article number	464
Number of pages	8
Journal	BMC Cancer
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12885-021-08168-x
Publication status	Published - 26 Apr 2021

Keywords

Colorectal peritoneal metastases
CRS-HIPEC
Surgical staging
MRI
RCT
HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY
CYTOREDUCTIVE SURGERY
COMPUTED-TOMOGRAPHY
LAPAROSCOPY
CARCINOMATOSIS
MANAGEMENT
INDEX

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Engbersen, M. P., Rijsemus, C. J., Nederend, J., Aalbers, A. G. J., de Hingh, I. H. J. T., Retel, Lambregts, D. M. J., Van der Hoeven, E. J. R. J., Boerma, D., Wiezer, M. J., De Vries, M., Madsen, E. V. E., Brandt-Kerkhof, A. R. M., Van Koeverden, S., De Reuver, P. R., Beets-Tan, R. G. H., Kok, N. F. M., & Lahaye, M. J. (2021). Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial. BMC Cancer, 21(1), Article 464. https://doi.org/10.1186/s12885-021-08168-x

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title = "Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial",

abstract = "BackgroundSelecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging.MethodsThe study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI>24) or explorative surgeries in patients with limited disease (PCI",

keywords = "Colorectal peritoneal metastases, CRS-HIPEC, Surgical staging, MRI, RCT, HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY, CYTOREDUCTIVE SURGERY, COMPUTED-TOMOGRAPHY, LAPAROSCOPY, CARCINOMATOSIS, MANAGEMENT, INDEX",

author = "Engbersen, {M. P.} and Rijsemus, {C. J.} and J. Nederend and Aalbers, {A. G. J.} and {de Hingh}, {I. H. J. T.} and Retel and Lambregts, {D. M. J.} and {Van der Hoeven}, {E. J. R. J.} and D. Boerma and Wiezer, {M. J.} and {De Vries}, M. and Madsen, {E. V. E.} and Brandt-Kerkhof, {A. R. M.} and {Van Koeverden}, S. and {De Reuver}, {P. R.} and Beets-Tan, {R. G. H.} and Kok, {N. F. M.} and Lahaye, {M. J.}",

year = "2021",

month = apr,

day = "26",

doi = "10.1186/s12885-021-08168-x",

language = "English",

volume = "21",

journal = "BMC Cancer",

issn = "1471-2407",

publisher = "BioMed Central Ltd",

number = "1",

}

Engbersen, MP, Rijsemus, CJ, Nederend, J, Aalbers, AGJ, de Hingh, IHJT, Retel, Lambregts, DMJ, Van der Hoeven, EJRJ, Boerma, D, Wiezer, MJ, De Vries, M, Madsen, EVE, Brandt-Kerkhof, ARM, Van Koeverden, S, De Reuver, PR, Beets-Tan, RGH, Kok, NFM & Lahaye, MJ 2021, 'Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial', BMC Cancer, vol. 21, no. 1, 464. https://doi.org/10.1186/s12885-021-08168-x

TY - JOUR

T1 - Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial

AU - Engbersen, M. P.

AU - Rijsemus, C. J.

AU - Nederend, J.

AU - Aalbers, A. G. J.

AU - de Hingh, I. H. J. T.

AU - Retel, null

AU - Lambregts, D. M. J.

AU - Van der Hoeven, E. J. R. J.

AU - Boerma, D.

AU - Wiezer, M. J.

AU - De Vries, M.

AU - Madsen, E. V. E.

AU - Brandt-Kerkhof, A. R. M.

AU - Van Koeverden, S.

AU - De Reuver, P. R.

AU - Beets-Tan, R. G. H.

AU - Kok, N. F. M.

AU - Lahaye, M. J.

PY - 2021/4/26

Y1 - 2021/4/26

N2 - BackgroundSelecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging.MethodsThe study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI>24) or explorative surgeries in patients with limited disease (PCI

AB - BackgroundSelecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging.MethodsThe study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI>24) or explorative surgeries in patients with limited disease (PCI

KW - Colorectal peritoneal metastases

KW - CRS-HIPEC

KW - Surgical staging

KW - MRI

KW - RCT

KW - HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY

KW - CYTOREDUCTIVE SURGERY

KW - COMPUTED-TOMOGRAPHY

KW - LAPAROSCOPY

KW - CARCINOMATOSIS

KW - MANAGEMENT

KW - INDEX

U2 - 10.1186/s12885-021-08168-x

DO - 10.1186/s12885-021-08168-x

M3 - Article

C2 - 33902498

SN - 1471-2407

VL - 21

JO - BMC Cancer

JF - BMC Cancer

IS - 1

M1 - 464

ER -

Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial

Abstract

Keywords

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