Recurrent intraabdominal cancer with intestinal obstruction.
The objective of this study was to evaluate short and long term results of management of recurrent intraabdominal malignancy causing intestinal obstruction using surgery and intraperitoneal chemotherapy and determine the clinical features that suggest favorable outcome. Forty two consecutive patients who were treated by cytoreductive surgery with or without intraperitoneal chemotherapy were retrospectively analyzed. There were 20 patients with primary tumors of appendix, 13 with cancer of colon or rectum, and 9 patients with cancer of other origins. All 42 patients were explored and extensively evaluated intraoperatively. Surgery included bowel resections and peritonectomy procedures. In 30 patients early postoperative intraperitoneal chemotherapy was administered. The overall morbidity was 55% while mortality was 7.14%. The projected three year survival for this group of patients was 32.7%. Among the most significant clinical features that reflect favorable prognosis were low histologic grade of malignancy, recurrence 2 and more years after primary surgery, and cancer that could be completely surgically excised. As a result of treatment patients' performance status improved in 47.6% of cases. An aggressive reoperative approach may be considered for palliation of selected patients with recurrent cancer causing intestinal obstruction.
Washington Cancer Institute, Washington Hospital Center, Washington, D.C. 20010, USA.
A M
AM
Averbach
P H
PH
Sugarbaker
D000008:Abdominal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D010166:Palliative Care; D011379:Prognosis; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome
D016685:Mitomycin; D005472:Fluorouracil