Summary of Program

Peritonectomy is a complex abdominal operation involving a combination of macroscopic tumour removal (cytoreductive surgery; CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) administered directly into the abdomen during surgery to kill any residual microscopic cancer cells following cytoreduction. This treatment approach has been shown to significantly increase survival, improve quality of life, and potentially offer a cure to patients with peritoneal metastases of colorectal or appendiceal origin, as well as metastatic gastric and ovarian cancer.

Due to increasing demand for this type of service, in October 2016 the NSW Government established a second state-wide Peritonectomy service at RPAH. This program has a foundation in patient monitoring and research, which includes interstate and international collaborations with other Peritonectomy centres. To ensure the continued pursuit of high quality, evidence-based practice, the patient data is centralised within a clinical and patient-reported outcomes (quality of life, work and health care utilisation) research database (PREMIER). This supports not only clinical auditing and reporting of data to the SLHD and NSW Ministry of Health (MoH), but also the ongoing development of research activity.

Highlights

  • The Peritoneal Malignancy Research Program at RPAH has collected information from all patients undergoing surgery to date, totaling 470 patients. This includes over 450 patients that consented to provide patient-reported outcome measures from baseline (before surgery) to 5 years postoperative.
  • In April 2022, the Peritoneal Malignancy Program completed 5 years. During this period, the program was able to secure several research grants to support the ongoing success of the program. These included competitive external funding from the National Health and Medical Research Council and the Medical Research Future Fund.
  • Currently, there are over 35 research studies being conducted in a wide range of areas including surgical techniques, surgical outcomes, survival, quality of life, nutrition, depression, anxiety, stress, pain, physical activity and health economics. These studies include:
    • AUS-UK QoL: An international cohort study investigating quality of life outcomes following CRS & HIPEC in colorectal cancer patients. This prospective study is the first international collaboration and involves the Royal Prince Alfred Hospital and Basingstoke Hospital from the UK. The study is currently recruiting participants in both sites.
    • ReLaPSeD Trial: A large multicentre randomised controlled trial investigating overall survival in patients managed with routine second look laparoscopy versus standard follow-up following curative resection for high-risk colorectal cancer. This trial started in May 2019 and is currently recruiting participants.
    • HyNOVA Trial: A multicentre randomised study comparing hyperthermic and normothermic intraperitoneal chemotherapy following interval cytoreductive surgery for stage III epithelial ovarian, fallopian tube and primary peritoneal cancer. This trial received external funds from the Medical Research Future Fund and is currently recruiting participants.

If you would like to get involved with our Peritoneal Malignancy Research Program, submit an expression of interest HERE.