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Treatment of peritoneal carcinomatosis with intent to cure
Author(s) -
Cavaliere Francesco,
Perri Pasquale,
Di Filippo Franco,
Giannarelli Diana,
Botti Claudio,
Cosimelli Maurizio,
Tedesco Manfredo,
Principi Francesca,
Laurenzi Lamberto,
Cavaliere Renato
Publication year - 2000
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/1096-9098(200005)74:1<41::aid-jso10>3.0.co;2-r
Subject(s) - medicine , surgery , peritoneum , peritoneal carcinomatosis , chemotherapy , peritoneal cavity , abdomen , hyperthermia , survival rate , cancer , colorectal cancer
Background and Objectives Low‐grade malignant tumors arise in the abdomen, do not infiltrate, and “redistribute” on the peritoneum with no extraregional spreading. In these cases, aggressive surgery combined with localized chemotherapy may provide cure. Methods After removing the tumor with the regional peritoneum en bloc, intraabdominal hyperthermic chemoperfusion was performed throughout the abdominopelvic cavity. Alternatively, early intraabdominal chemotherapy, starting on the first postoperative day, was administered for 5 days. Results Forty patients affected with extensive peritoneal carcinomatosis underwent peritonectomy, with no residual macroscopic disease except in four cases. Seventy‐five percent of the patients underwent locoregional chemotherapy. Major complications were observed in 40% of the patients and led to death in five; there was a direct correlation to the duration of surgery ( P = 0.03). At a mean follow‐up of 20 months, the overall 2‐year survival was 61.4%, with a median survival of 30 months. Conclusions After a learning curve of 18 months, the feasibility of the integrated treatment increased to greater than 90%, and mortality dramatically decreased. The combined treatment resulted in a high survival rate in patients with extensive carcinomatosis who were no longer responsive to traditional therapies. J. Surg. Oncol. 2000:74:41–44. © 2000 Wiley‐Liss, Inc.