Cytoreductive approach to peritoneal carcinomatosis

Abstract

Purpose: To present our clinical experience on the combined (surgicochemotherapeutic) treatment of peritoneal carcinomatosis. Patients and methods: Thirteen patients (six men and 7 women) with a mean age of 53 years (range 23-75) with peritoneal carcinomatosis (11 colorectal carcinoma, 1 ovarian carcinoma, and 1 malignant peritoneal mesothelioma) were treated with a cytoreductive approach (CRA) that consisted of cytoreductive surgery (CRS), early postoperative intraperitoneal chemotherapy (IPCT), and late systemic chemotherapy. CRS aimed at removing all visible disease. Patients with colorectal and ovarian cancer received IPCT with mitomycin-C 10 mg/m2 (postop. day 1). On postop, days 2-5, 5-fluorouracil (5-FU) 15 mg/kg/day was administered. The patient with mesothelioma received IPCT with adriamycin 0.1 mg/kg/day on postop, days 1-5. Late systemic chemotherapy with 5-FU 450 mg/m2/day and leucovorin 20 mg/m2/day for 5 consecutive days every 3 weeks and for a total of 6 cycles, was administered to all patients. Results: No major complications were encountered in 9 (69%) patients. In 10 (77%) patients complete removal of all visible disease was achieved. The mean survival of all patients was 17 months. Four patients are still alive with no evidence of disease for a mean survival time of 27+ months. Conclusion: The results in our small series indicate that the CRA seems to have some noticeable beneficial effects for patients with peritoneal carcinomatosis

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