Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy.

摘要: BACKGROUND Peritoneal carcinomatosis (PC) is fatal, despite standard systemic chemotherapy. A new approach that combines maximal surgery with regional chemotherapy has potential to cure selected patients who have colorectal PC. The authors reported the oncologic results of this combined treatment. METHODS The performed a retrospective study 64 had PC arising from adenocarcinomas, 19 (29.6%) whom also other metastases. These were treated by complete resection all detectable tumors and 5-day course early intraperitoneal (EPIC) mitomycin C, then 5-fluorouracil (n = 37), or intraoperative chemohyperthermia (IPCH) alone cisplatin 27), in 2 separate trials. In trial IPCH, aimed at selecting most reliable procedure terms spatial diffusion thermal homogeneity, 27 7 different procedures. extent was assessed precisely using peritoneal index. median follow-up period for entire patient population 51.7 months. RESULTS The postoperative mortality morbidity rates 9.3% 54.6%, respectively. Most severe complications occurred required extensive cytoreductive surgery. Global disease-free survival respectively 60.1% 54.7% years 27.4% 18.4% 5 years. Results significantly better (P 0.04) when metastasis-free (apart PC) index lower than 16 0.005). IPCH seemed be more effective EPIC treatment PC. CONCLUSION This plan, which chemotherapy, cured approximately 25% patients. This strategy mainly applicable limited cancer volume no extraperitoneal involvement. proved but difficult use correctly. Future should improve through routine optimal hyperthermia procedure, improvements composition instillate, selection, reduction rate occurs physician experience. Cancer 2001;92:71–6. © 2001 American Society.