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Management of peritoneal-surface malignancy: the surgeon's role
1Washington Cancer Institute, Washington Hospital Center, Washington, DC 20010, USA.
Langenbeck'S Archives of Surgery
|February 2, 2000
Summary
Aggressive treatment of peritoneal surface malignancy, including peritonectomy and chemotherapy, offers a curative approach for selected patients. Early intervention in peritoneal cancer spread significantly improves long-term survival rates.
Area of Science:
- Surgical Oncology
- Medical Oncology
- Gastrointestinal Oncology
Background:
- Peritoneal surface malignancy arises from gastrointestinal cancers, sarcomas, or primary peritoneal diseases like mesothelioma.
- Historically, treatment for peritoneal surface malignancy was solely palliative.
Purpose of the Study:
- To evaluate the efficacy of an aggressive multimodal treatment approach for peritoneal surface malignancy.
- To identify key factors for patient selection to optimize treatment outcomes.
Main Methods:
- Involved peritonectomy procedures and perioperative intraperitoneal chemotherapy.
- Utilized cancer histopathology, computed tomography scans, peritoneal cancer index, and completeness of cytoreduction score for patient selection.
Main Results:
- Appendiceal tumors with peritoneal seeding showed 75% long-term survival in selected patients.
- Colon cancer carcinomatosis survival reached 50% in selected patients (overall 20%).
- Sarcomatosis survival reached 75% in selected patients (overall 10%).
Conclusions:
- Knowledgeable surgical management is crucial for peritoneal surface dissemination of cancer.
- A curative approach is feasible for selected patients with peritoneal surface malignancy.
- Further adjuvant studies with perioperative intraperitoneal chemotherapy are indicated.