Physicians’ awareness of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer carcinomatosis

Physicians' awareness of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer carcinomatosis

Can J Surg 2013;56(4)237-242 | PDF

Gillian Spiegle, BHSc*, Selina Schmocker, BSc†, Harden Huang, BHSc†, J. Charles Victor, MSc‡§, Calvin Law, MD, MPH‡§¶**, J. Andrea McCart, MD, MSc§††, Erin Diane Kennedy, MD, PhD†§**††

From the *Department of Medicine, University of Toronto, the †Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, the ‡Institute of Clinical Evaluative Sciences (ICES), the §University of Toronto, the ¶Department of Surgery, Sunnybrook Health Sciences Centre, the **Department of Health Policy, Management and Evaluation, University of Toronto, and the ††Division of General Surgery, Mount Sinai Hospital, Toronto, Ont.

Abstract

Background: Recent trials have shown that cytoreductive surgery and heated intraperitoneal chemotherapy (S+HIPEC) for colorectal cancer carcinomatosis (CRC-C) leads to 5-year, disease-free survival rates of more than 30%. Since these data represent a substantial change in the management of CRC-C, the objectives of this study were to determine physicians’ awareness of S+HIPEC for CRC-C and physician characteristics predictive of awareness of S+HIPEC for CRC-C.

Methods: This study was a mailed, cross-sectional survey of general surgeons and medical oncologists in Ontario.

Results: The response rate was 44.0% (214 of 487). Most respondents were men and younger than 50 years. There was an even split between those at academic and community hospitals. Overall, 46% of respondents were aware of S+HIPEC for CRC-C, and multivariate analysis showed that there were no physician characteristics predict – ive of awareness of S+HIPEC for CRC-C.

Conclusion: Physician awareness of S+HIPEC for CRC-C is low. Therefore, strategies to improve patient and physician knowledge about S+HIPEC for CRC-C are important to ensure appropriate treatment for patients.

Résumé

Contexte : Des essais récents ont démontré que la chirurgie de réduction tumorale combinée à la chimiothérapie intrapéritonéale hyperthermique (S+HIPEC) contre la carcinomatose du cancer colorectal (C-CCR) produit des taux de survie sans maladie de 5 ans qui dépassent 30 %. Comme ces données représentent une modification importante de la prise en charge de la C-CCR, l’étude visait à déterminer si les médecins connaissent la technique S+HIPEC contre la C-CCR et les caractéristiques des médecins qui prédisent une connaissance de la technique S+HIPEC contre la C-CCR.

Méthodes : L’étude consistait en un sondage transversal postal mené auprès de chirurgiens généraux et de médecins oncologues de l’Ontario.

Résultats : Le taux de réponse a atteint 44,0 % (214 sur 487). La plupart des répondants étaient des hommes de moins de 50 ans. La répartition entre les hôpitaux universitaires et les hôpitaux communautaires était égale. Dans l’ensemble, 46 % des répondants connaissaient la technique S+HIPEC contre la C-CCR et une analyse à variables multiples a montré qu’il n’y avait pas de caractéristiques des médecins qui pouvaient prédire la connaissance de la technique S+HIPEC contre la C-CCR.

Conclusion : Les médecins connaissent peu la technique S+HIPEC contre la C-CCR. Des stratégies visant à améliorer la connaissance de la technique S+HIPEC contre la C-CCR chez les patients et les médecins sont importantes pour assurer le traitement approprié des patients.


Presented at the Canadian Surgical Forum, September 2009, Victoria, BC

Accepted for publication Aug. 10, 2012

Competing interests: None declared.

Contributors: G. Spiegle, C. Law, J.A. McCart and E. Kennedy designed the study. G. Spiegle, S. Schmocker, H. Huang, J.A. McCart and E. Kennedy acquired the data. All authors analyzed the data and reviewed the article. G. Spiegle, S. Schmocker, J.A. McCart and E. Kennedy wrote the article. All authors approved its publication.

DOI: 10.1503/cjs.003912

Correspondence to: E. Kennedy Mount Sinai Hospital 600 University Ave., Room 455 Toronto ON M5G 1X5 ekennedy@mtsinai.on.ca