This study will investigate the tumor-associated vasculature of patients with peritoneal carcinomatosis, or cancer that spreads along the inner abdominal lining. The investigators will use a technology known as intravital microscopy (IVM) in order to visualize in real-time the tumor-associated vessels of peritoneal disease. The IVM observations may determine if an individual patient's tumor vessels would be amenable to receiving systemic therapy, based on the functionality of the vessels.
Primary objective(s): To determine the feasibility and clinical utility of performing HIVM in patients with peritoneal carcinomatosis during standard course of treatment (cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, or CRS-HIPEC). Secondary objective(s): 1. Compare the microscopic observation of the tumor-associated vessels with normal tissue (peritoneal surface) in each individual subject. 2. Correlate the microscopic observations of the tumor-associated vessels with pathologic grade of tumor implants. 3. Correlate the microscopic observation of the microvasculature with tumor-specific and overall survival.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
30
Intravital microscopy (IVM) allows real-time, direct visualization of microscopic blood vessels and calculation of blood flow.
Mayo Clinic Florida
Jacksonville, Florida, United States
Tumor vessel identification (# tumor vessels visualized per high power field)
Identify and measure vessels associated with peritoneal tumor implants
Time frame: 15-20 minutes
Tumor vessel density (# tumor vessels per square cm area observed)
Determine vessel density per 10x field
Time frame: 15-20 minutes
Fluorescent dye uptake (# tumor vessels with fluorescent dye uptake and # tumor vessels without dye uptake)
Visualize vital dyes within the vessels \[fluorescein and indocyanine green (ICG)\]
Time frame: 15-20 minutes
Tumor blood flow (velocity, mm/sec)
Calculate the blood flow velocity of the vessels and tissue penetration of fluorescent dyes as markers of vessel permeability.
Time frame: 15-20 minutes
Post-operative comparison of the microvasculature of peritoneal carcinomatosis with normal tissue (peritoneum)
The investigators will compare the microvasculature of peritoneal carcinomatosis with normal tissue (peritoneum) in each individual subject using vessel characteristics (diameters, vessel density, detection of intravital dye and flow rates).
Time frame: 15-20 minutes
Post-operative correlation of the microvasculature with pathologic features of the tumor implants (i.e. tumor grade) at the time of the final pathology report (5-7 days after surgery).
The investigators will determine if there is a correlation between the microvasculature with pathologic features of the tumor implants (i.e. tumor grade) at the time of the final pathology report (5-7 days after surgery).
Time frame: 5-7 days
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Post-operative correlation of the microscopic observation of the tumor microvasculature tumor-specific and overall survival.
The investigators will determine if there is a correlation between the microscopic observation of the tumor microvasculature tumor-specific and overall survival.
Time frame: 5 years