Questions for Specialists
It is highly recommend that appendix cancer and PMP patients seek out a specialist who deals with these conditions on a regular basis. Here are some important questions to ask your specialists.
- How many cytoreductive surgeries have you performed (studies have shown that the peak of the learning curve for CRS/HIPEC is 130, 140, 180, or even over 200 procedures)?
- What percentage of these CRS surgeries performed were done specifically to treat PMP/Appendix Cancer?
- How many years of experience do you have performing these surgeries?
- In approximately what percentage of surgeries do you use hyperthermic intraperitoneal chemotherapy (HIPEC)?
- What chemo agents do you use for HIPEC, and why?
- Do you perform HIPEC using the open or closed technique? Why do you believe this method is superior?
- Do you perform HIPEC only during surgery, or do you continue early post-operative intraperitoneal chemotherapy (EPIC) for some days after surgery?
- How many days do you estimate for a post-surgical hospital stay? Do you have a set timeframe, or is it based solely on post-op milestones? What are those milestones?
- What is a typical operating time for cytoreductive surgery?
- What are your current outcome statistics for disease-free survival for LAMN (DPAM), HAMN (PMCA), PMCA-I (intermediate), appendiceal adenocarcinoma (with and without signet ring cells), and goblet cell carcinoid tumors?
- What is your philosophy about using systemic chemo before and/or after surgery?
- What chemotherapy agents (including systemic “cocktails”) do you use/recommend and why?
- Are there any special therapies you provide? If any, can you provide research on which they are based? Are you pursuing this therapy in a research context?
- What is your average (or typical) patient age and gender?
- Do you recommend chemo sensitivity assays? Why or why not? If yes, what lab(s) do you use?
- Do you recommend molecular assays of tumor samples? Why or why not? If yes, what lab(s) do you use?
- What is the typical waiting time for a patient to be scheduled for surgery?
- Please describe your surgical selection criteria (for LAMN (DPAM), HAMN (PMCA), PMCA-I (intermediate), appendiceal adenocarcinoma [with and without signet ring cells], and goblet cell carcinoid tumors).