[New philosophy in the treatment of peritoneal carcinomatosis of gastrointestinal origin].
Cancer of the various organs of the abdominal cavity accounts for approximately 40% of yearly deaths in western countries. A frequently contributing factor is peritoneal carcinomatosis. The traditional approach to peritoneal carcinomatosis has been to renounce further surgical treatment, and resort to palliative chemotherapy. Tumour mass reduction by surgical debulking alone does not benefit the patient. Over the past decade, studies have shown that surgical debulking, (cytoreduction), combined with synchronous intraperitoneal chemotherapy provides good, and occasionally spectacular, results. The most significant results were initially obtained in the treatment of peritoneal pseudomyxoma and further studies have demonstrated the effectiveness of this combined approach in the treatment of colon, gastric and ovarian cancer. The statistical benefit gained by such treatment is thus far indiscutable. It should also be noted that the addition of perioperative hyperthermia appears to increase the effectiveness of treatment. While awaiting further options for the treatment of peritoneal carcinomatosis, notably in the arena of immuno- or genetic therapy, it is certain that combined cytoreduction/intraperitoneal chemotherapy/hyperthermia, is a feasible approach with proven benefit that should be included in current clinical protocols.
Jacquet
N
N
Service de chirurgie abdominale, Centre hospitalier de l'Université de Liège au Sart-Tilman.
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D003131:Combined Modality Therapy; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome
D000970:Antineoplastic Agents