A Yale team of researchers led by noted Indian American oncologist Dr. Kiran Turaga has developed new national guidelines for peritoneal surface malignancies (PSMs) or cancers in the lining of the abdominal cavity.
The new consensus guidelines developed by a consortium of more than 500 physicians, allied professionals, patient organizations, and international urge more robust clinical trials to provide reliable data on which to further hone therapies and treatment pathways. The new best practices national guidelines for PSMs were published jointly June 25-26 by the journals Cancer and Annals of Surgical Oncology.
PSMs can start from the abdominal cavity, or can spread from primary cancers including colorectal, gastric, ovarian, and of the appendix, according to a news release from Yale School of Medicine.
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Some 70,000 individuals in the U.S. are estimated to develop these metastases annually. The first attempt to create a unified approach for the management of these diseases resulted in the 2018 Chicago consensus.
“This time our secret sauce was the numerous trainees, medical students, residents and fellows across the country who lent their enthusiasm and leadership to this cause,” says Turaga, Yale’s Chief of Surgical Oncology
“Using ‘small world networks’ led by faculty experts and Yale trainees, the team worked with more than 317 contributors, examined over 13,000 articles, performed 11 rapid reviews and developed nine clinical management pathways that were rigorously evaluated by epidemiologists, patient and professional organizations.
“The remarkable environment provided by Yale made this possible. We were able to use the expertise of the library and the School of Public Health faculty for our rapid reviews, Yale Center for Clinical Investigation (YCCI) for our surveys of experts, and teaching and learning resources from around Yale, including the Poorvu Center to develop a pedagogical framework,” adds Turaga, a member of the Yale Cancer Center.
In addition to being endorsed by the Society of Surgical Oncology at the start of 2025, as well as being incorporated into the National Comprehensive Cancer Network, the guidelines led to the development of an educational curriculum for trainees, and resources for patients and physicians.
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The authors conducted a national survey of surgeons performing CRS/HIPEC procedures and established standard of benchmarks for these procedures, noting the significant variability and lack of support for surgeons earlier in their experience.
Turaga joined Yale Cancer Center and Smilow Cancer Hospital from the University of Chicago where he was Vice Chief of the Section of General Surgery and Surgical Oncology, Director of the Surgical Gastrointestinal Cancer Program, and Director of Regional Therapeutics.
Widely considered a thought leader in the management of oligometastatic cancer, Turaga is an expert in regional perfusion including hyperthermic intraperitoneal chemotherapy (HIPEC), a technique that delivers high doses of heated chemotherapy directly to abdominal organs to kill cancer cells that may remain after surgical removal of visible tumors.
His research focuses on development of novel diagnostics and therapeutics for oligometastatic cancer and is currently the principal investigator on several clinical trials exploring the interface of immunotherapy and liquid biopsy in the surgical management of cancer. He is also interested in studying how big data systems can be used to provide the most optimal, cost-effective patient care.