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Peritoneal carcinomatosis of unknown primary site in women. A distinctive subset of adenocarcinoma
C M Strnad1, W W Grosh, J Baxter
1Vanderbilt University Medical Center, Nashville, Tennessee.
Annals of Internal Medicine
|August 1, 1989
Summary
This study found that women with peritoneal adenocarcinoma of unknown primary site have a better prognosis and response to treatment. Optimal treatment involves surgery and cisplatin-based chemotherapy for potential long-term survival.
Area of Science:
- Gynecologic Oncology
- Medical Oncology
- Surgical Oncology
Background:
- Adenocarcinoma of unknown primary site (AUP) presents a diagnostic challenge.
- Peritoneal carcinomatosis in AUP suggests a specific clinical behavior.
- Distinguishing peritoneal AUP is crucial for appropriate management.
Purpose of the Study:
- To define clinical features of AUP involving peritoneal surfaces.
- To evaluate systemic treatment outcomes in these patients.
- To establish prognostic factors and treatment recommendations.
Main Methods:
- Retrospective analysis of 18 patients with peritoneal AUP.
- Initial laparotomy with cytoreductive surgery.
- Cisplatin-based chemotherapy in 16 patients.
- Clinical restaging or second-look surgery.
Main Results:
- Median survival was 23 months for all patients.
- Five patients achieved complete response to chemotherapy.
- Limited residual disease after surgery correlated with longer survival (31 vs. 11 months).
Conclusions:
- Peritoneal AUP has a more indolent course than other AUP.
- These patients show a higher response rate to systemic therapy.
- Treatment guidelines for advanced ovarian carcinoma, including surgery and chemotherapy, are recommended.