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Intraperitoneal chemotherapy in disseminated abdominal sarcoma
C P Karakousis1, K Kontzoglou, D L Driscoll
1State University of New York, Millard Fillmore Hospital, Buffalo, NY 14209, USA.
Annals of Surgical Oncology
|October 6, 1997
Summary
Cytoreductive surgery combined with intraperitoneal chemotherapy shows feasibility for intra-abdominal sarcomas. However, this approach yielded a limited 5-year survival rate of 7% in the studied patient cohort.
Area of Science:
- Surgical Oncology
- Medical Oncology
- Clinical Research
Background:
- Limited literature exists on cytoreductive surgery (CRS) with intraperitoneal chemotherapy (IPEC) for intra-abdominal sarcomas.
- Sarcomas with intra-abdominal dissemination present unique treatment challenges.
Purpose of the Study:
- To evaluate the efficacy and outcomes of CRS followed by IPEC in patients with intra-abdominal sarcomas.
- To assess the feasibility of complete macroscopic tumor resection and subsequent survival rates.
Main Methods:
- A prospective study involving 28 patients with intra-abdominal sarcomas.
- Procedures included exploratory laparotomy, complete macroscopic tumor resection (cytoreduction), and intraperitoneal chemotherapy with cisplatin (cis-DDP).
- Patients underwent follow-up second-look operations to assess tumor recurrence and catheter status.
Main Results:
- Complete macroscopic tumor resection was achieved in 79% of patients.
- Five-year survival rates were 54% at year 1, decreasing to 7% by year 5.
- Second-look procedures revealed dense adhesions surrounding the intraperitoneal catheter in 19 out of 20 patients, with localized tumor control around the catheter in most cases.
Conclusions:
- Cytoreductive surgery is feasible for removing macroscopic intra-abdominal sarcomas in a majority of patients.
- Intraperitoneal chemotherapy with cis-DDP following CRS demonstrated a low 5-year survival rate of 7%.