Read CHEMUCCA part I in European Journal of Surgical Oncology Mucinous condition is not deleterious for systemic chemo in stage III even in high risk stage II colon cancer. INDEPSO Peritoneal Surface Oncology Group International European Society of Surgical Oncology (ESSO) ESMO - Eur. Oncology Grupo Español de Tratamiento de Tumores Digestivos Hospital Universitario Reina Sofía IMIBIC kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F%2…

Looking forward to presenting the 1st results of the consensus on CRS-nomenclature & boundaries of peritonectomy procedures A joint effort of the Peritoneal Surface Oncology Group International ESGO & ISSPP with Artem Stepanyan Alvaro Arjona Vahan Képénékian Fotopoulou/Cunnea Ovarian Cancer Research group #shigekikusamura #brendanmoran

onlinelibrary.wiley.com/doi/10.1002/js…

Great insights on the management of metastatic colorectal cancer with #AnilVaidya #MasatoFujiki and our very own Faheez Mohamed Fantastic organisation by #dileepdamodaran and #sivakumar Exciting developments in mx of PMP and other end stage dz in India Watch this space for more..

3️⃣ weeks to go !!! #Lyon2024 🌟 Prof. Clarisse Dromain will join the congress - Renowned Radiologist 🌟 We are delighted to announce that Prof. Clarisse Dromain, one of PSOGI-ISSPP's most esteemed radiologists, will be joining us in Lyon for a highly informative presentation.

#PSOGICASE Paul H Sugarbaker Upper GI endoscopy showed a growth in the antrum and pylorus with luminal narrowing, scope could be negotiated beyond the growth. Biopsy- well differentiated adenocarcinoma All blood tests (hematologic and biochemical) were normal except a low

Paul H Sugarbaker European Society of Surgical Oncology (ESSO) EYSAC @Some4SurgeryITeam SoMe4Surgery YoungOncologistsUnited Young Oncologists Group India🇮🇳 Asociación Peritoneum ISSPP Kiran Turaga Lana Bijelic Alvaro Arjona Mufaddal Kazi RENAPE Network Cesar Nevarez Graber Guillermo Şafak Gül Faheez Mohamed Kurt Van der Speeten Peter Cashin Society of Surgical Oncology Swapnil Patel Gastric Cancer Foundation #PSOGICASE Paul H Sugarbaker What other investigations are needed?

Paul H Sugarbaker European Society of Surgical Oncology (ESSO) EYSAC @Some4SurgeryITeam SoMe4Surgery YoungOncologistsUnited Young Oncologists Group India🇮🇳 Asociación Peritoneum ISSPP Kiran Turaga Lana Bijelic Alvaro Arjona Mufaddal Kazi RENAPE Network Cesar Nevarez Graber Guillermo Şafak Gül Faheez Mohamed Kurt Van der Speeten Peter Cashin Society of Surgical Oncology Swapnil Patel Gastric Cancer Foundation #PSOGICASE Paul H Sugarbaker What would be your plan of management? •Would you ever consider upfront surgery for this patient?

Peritoneal Surface Oncology Group International European Society of Surgical Oncology (ESSO) EYSAC @Some4SurgeryITeam SoMe4Surgery YoungOncologistsUnited Young Oncologists Group India🇮🇳 Asociación Peritoneum ISSPP Kiran Turaga Lana Bijelic Alvaro Arjona Mufaddal Kazi RENAPE Network Cesar Nevarez Graber Guillermo Şafak Gül Faheez Mohamed Kurt Van der Speeten Peter Cashin Society of Surgical Oncology Swapnil Patel Gastric Cancer Foundation With no peritoneal metastases or a very low PCI, gastrectomy + CRS + HIPEC is preferred. Too many patients who are resectable progress on prolonged treatment with neoadjuvant chemotherapy.

Peritoneal Surface Oncology Group International European Society of Surgical Oncology (ESSO) EYSAC @Some4SurgeryITeam SoMe4Surgery YoungOncologistsUnited Young Oncologists Group India🇮🇳 Asociación Peritoneum ISSPP Kiran Turaga Lana Bijelic Alvaro Arjona Mufaddal Kazi RENAPE Network Cesar Nevarez Graber Guillermo Şafak Gül Faheez Mohamed Kurt Van der Speeten Peter Cashin Society of Surgical Oncology Swapnil Patel Gastric Cancer Foundation Yes, these patients with positive cytology should be treated with CRS with gastrectomy and HIPEC. Multiple HIPECs with oxaliplatin and 5-FU would be preferred if it is available at your institution.

Peritoneal Surface Oncology Group International European Society of Surgical Oncology (ESSO) EYSAC @Some4SurgeryITeam SoMe4Surgery YoungOncologistsUnited Young Oncologists Group India🇮🇳 Asociación Peritoneum ISSPP Kiran Turaga Lana Bijelic Alvaro Arjona Mufaddal Kazi RENAPE Network Cesar Nevarez Graber Guillermo Şafak Gül Faheez Mohamed Kurt Van der Speeten Peter Cashin Society of Surgical Oncology Swapnil Patel Gastric Cancer Foundation The response by CT is impressive. Gastrectomy is now indicated.

Peritoneal Surface Oncology Group International European Society of Surgical Oncology (ESSO) EYSAC @Some4SurgeryITeam SoMe4Surgery YoungOncologistsUnited Young Oncologists Group India🇮🇳 Asociación Peritoneum ISSPP Kiran Turaga Lana Bijelic Alvaro Arjona Mufaddal Kazi RENAPE Network Cesar Nevarez Graber Guillermo Şafak Gül Faheez Mohamed Kurt Van der Speeten Peter Cashin Society of Surgical Oncology Swapnil Patel Gastric Cancer Foundation Laparoscopy is a necessary preliminary to gastrectomy with advanced gastric cancer.

Guillermo Paul H Sugarbaker #PSOGICASE Paul H Sugarbaker A staging laparoscopy was performed There was one nodule on the right subphrenic peritoneum measuring 1 cm and a large omental nodal mass. PCI-2 No other peritoneal disease was visible Biopsy from the diaphragmatic lesion was positive What should

Guillermo Paul H Sugarbaker #PSOGICASE Paul H Sugarbaker Is this missed peritoneal disease or disease progression?

Peritoneal Surface Oncology Group International Guillermo Surgery in an attempt to make this patient disease-free and thereby prolong his survival is indicated now. Further delay in definitive gastrectomy plus CRS should be avoided. Yes, I would use HIPEC with MMC and cisplatin.

Peritoneal Surface Oncology Group International Paul H Sugarbaker Fantastic question . After MDT discussion, from my surgical point of view . GOOD Status performance. Well differentiated disease. PCI lower than 6 Would proceed with CRS HIPEC

Paul H Sugarbaker Guillermo #PSOGICASE Paul H Sugarbaker What should be the ideal time for performing CRS-HIPEC in patients with gastric PM?

Paul H Sugarbaker Guillermo #PSOGICASE Paul H Sugarbaker •1 x 1 cm nodule on the tip of the appendix with other tiny nodules around it •Extensive scarring and thickening of the right parietal and paracolic and right subphrenic peritoneum •4 nodules on the small bowel 2 nodules – 5mm in size on the jejunal

Paul H Sugarbaker Guillermo #PSOGICASE Paul H Sugarbaker What would you do next ?

Paul H Sugarbaker Guillermo #PSOGICASE Paul H Sugarbaker What HIPEC regimen should be used? •Cisplatin and doxorubicin combination •Cisplatin and mitomycin C •Cisplatin single agent •Oxaliplatin based regimen