[Peritoneal carcinosis in appendiceal carcinoma--at what price can the prognosis be improved?]

Many patients with appendix carcinoma develop peritoneal carcinomatosis with poor prognosis. The purpose of this study was to look for results of multimodality treatment in these patients.

Data of 13 patients (11 men, 2 women, median age 58 years) with proven peritoneal carcinomatosis from appendiceal carcinoma, operated between 07/1995 and 10/1998 were analysed retrospectively with special regard to extent of resection, postoperative morbidity and mortality, survival.

A macroscopically complete cytoreduction could be achieved in all patients by multivisceral resection with peritonectomy. Intraoperatively, after resection, an open, hyperthermic intraperitoneal chemotherapy with Cisplatin was performed. Morbidity and 90-days-mortality were 62% and 15%, respectively. After a median follow-up of 36 months all patients survived the therapy (excepting two postoperative deaths).

In selected patients with advanced appendix carcinoma and peritoneal carcinomatosis prognosis can be improved by peritonectomy with intraperitoneal hyperthermic chemotherapy. This results in high mortality and morbidity.