Mucinous adenocarcinoma of the small bowel with peritoneal seeding.
OBJECTIVE
Small bowel adenocarcinoma has an extremely poor prognosis because of delayed diagnosis and the presence of advanced disease. Carcinomatosis associated with a small bowel primary cancer has not been reported to be successfully treated in the past.


METHODS
The clinical information prospectively recorded on six patients with carcinomatosis from small bowel adenocarcinoma was reviewed. All of these patients were treated with an aggressive local--regional strategy that utilized cytoreductive surgery plus peri-operative intraperitoneal mitomycin C and 5-fluorouracil.


RESULTS
Disease control in the abdomen and pelvis was achieved in four of these patients. Their median survival was 12 months with one patient alive and well at 4.5 years.


CONCLUSIONS
Small bowel adenocarcinoma continues to provide a surgical challenge. Complete resection of all visible disease combined with intraperitoneal chemotherapy to eradicate microscopic residual disease should be considered as an option in patients with carcinomatosis.
Marchettini
P
P
The Washington Cancer Institute, Washington Hospital Center, 110 Irving Street, NW, Washington, DC 20010, USA.
Sugarbaker
P H
PH
D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007263:Infusions, Parenteral; D007580:Jejunal Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin; D005472:Fluorouracil