Total abdominal colectomy, pelvic peritonectomy, and end-ileostomy for the surgical palliation of mucinous peritoneal carcinomatosis from non-gynecologic cancer.
OBJECTIVE
The optimal management of symptomatic advanced peritoneal carcinomatosis of non-gynecologic origin is not defined. Historic controls of surgical efforts report high postoperative mortality and morbidity rates with equivocal palliation. Novel surgical procedures need to be tested in terms of the impact on survival and quality of life.


METHODS
We studied 46 consecutive patients who underwent total abdominal colectomy, pelvic peritonectomy with construction of an end-ileostomy for palliation of peritoneal carcinomatosis.


RESULTS
Total abdominal colectomy, pelvic peritonectomy, and end-ileostomy was successfully performed in 46 patients of median age of 54.4 years. Overall median survival was 10.7 months, with a mean follow-up period of 12 months. Patients with appendiceal malignancy had a median survival of 19.7 months. Prognosis was poorer for patients with colon cancer, who had a median survival of 7.0 months, while patients with primary peritoneal carcinomatosis had a median of 7.8 months. Postoperative morbidity and mortality rates were 19.5 and 8.6%, respectively.


CONCLUSIONS
Total abdominal colectomy, pelvic peritonectomy, and end-ileostomy is a technically feasible procedure and is advocated for the palliation of patients with peritoneal carcinomatosis of appendiceal origin. It is not clear if the procedure should be advocated for more invasive gastrointestinal malignancies.
Stamou
Konstantinos M
KM
Washington Cancer Institute, Washington Hospital Center, NW, Washington, DC 20010, USA.
Karakozis
Stavros
S
Sugarbaker
Paul H
PH
D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001063:Appendiceal Neoplasms / Q000401:mortality / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003082:Colectomy; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007081:Ileostomy; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D010537:Peritoneum / Q000601:surgery*; D015996:Survival Rate
D016685:Mitomycin; D004317:Doxorubicin; D002945:Cisplatin