Peritoneal carcinomatosis in nongynecologic malignancy. A prospective study of prognostic factors.
Regional recurrence of malignant tumors in the peritoneal cavity usually signifies a poor prognosis for the host and often results in gastrointestinal complications requiring surgical intervention. One hundred patients with nongynecological malignancies found with peritoneal carcinomatosis were followed prospectively. The most common primary tumors were colorectal (N = 45) and pancreatic (N = 20) carcinoma. When associated with pancreatic carcinoma, 65% of patients had liver metastases and 60% had ascites. The presence of ascites was associated with poor survival, with no patient surviving past 30 days. Ascites was also a sign of poor prognosis in patients with colorectal carcinoma. Among possible prognostic factors in colorectal carcinoma patients, only disease-free interval, presence of lung metastases, and ascites showed statistically significant correlations with survival. Peritoneal carcinomatosis in sarcoma (N = 7) and breast cancer (N = 6) patients had median survival of 12 and 7 months, respectively. Surgical intervention for gastrointestinal complications in peritoneal carcinomatosis can provide significant palliation, with a few exceptions such as in patients with pancreatic or gastric carcinoma, ascites, and poor performance status.
Chu
D Z
DZ
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock 72205.
Lang
N P
NP
Thompson
C
C
Osteen
P K
PK
Westbrook
K C
KC
D000328:Adult; D001201:Ascites / Q000401:mortality; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D012086:Reoperation
D002272:Carcinoembryonic Antigen