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Recurrent intraabdominal cancer with intestinal obstruction
1Washington Cancer Institute, Washington Hospital Center, Washington, D.C. 20010, USA.
International Surgery
|April 1, 1995
Summary
Aggressive surgery and intraperitoneal chemotherapy can palliate recurrent intraabdominal malignancy causing intestinal obstruction. Favorable outcomes are linked to low-grade tumors, delayed recurrence, and complete surgical removal.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Recurrent intraabdominal malignancy frequently causes intestinal obstruction.
- Management options for such cases are limited, often focusing on palliative care.
Purpose of the Study:
- To evaluate the short and long-term outcomes of managing recurrent intraabdominal malignancy causing intestinal obstruction.
- To identify clinical features associated with a favorable prognosis in these patients.
Main Methods:
- Retrospective analysis of 42 consecutive patients treated with cytoreductive surgery and intraperitoneal chemotherapy.
- Surgical procedures included bowel resections and peritonectomy.
- Intraperitoneal chemotherapy was administered postoperatively in 30 patients.
Main Results:
- Overall morbidity was 55% and mortality was 7.14%.
- Projected three-year survival was 32.7%.
- Improved performance status was observed in 47.6% of patients.
Conclusions:
- Low histologic grade, recurrence occurring 2+ years post-primary surgery, and complete surgical excision are favorable prognostic indicators.
- An aggressive reoperative approach can be considered for palliation in selected patients with recurrent malignant intestinal obstruction.