Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma.
BACKGROUND
Peritoneal carcinomatosis (PC) is associated with a dismal prognosis. Small bowel adenocarcinoma is a rare etiology for PC. Due to the rarity, poor prognosis, and lack of standard treatment, we chose to review our experience with this disease process treated with cytoreductive surgery (CS) and intraperitoneal hyperthermic chemotherapy (IPHC).


METHODS
From a prospective database of IPHC patients, six patients diagnosed with PC from adenocarcinoma of the small bowel were identified. Between 1995 and 2004 these patients underwent CS and IPHC with Mitomycin C. A retrospective review was performed on these patients with mortality as the primary outcome measure.


RESULTS
Three of the six patients in this series are still alive, with a mean follow-up of 19.7 months after treatment with CS and IPHC. Three patients died of disease progression 29, 30, and 45 months after IPHC. Median survival after diagnosis of small bowel adenocarcinoma was 54 months, while median survival after CS and IPHC for PC was 30.1 months.


CONCLUSIONS
Small bowel adenocarcinoma with PC remains an unusual therapeutic challenge. Treatment with CS and IPHC is an attractive option for patients in this setting.
Jacks
Samuel P
SP
Surgical Oncology Service of the Department of General Surgery and the Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina 27157, USA.
Hundley
Jonathan C
JC
Shen
Perry
P
Russell
Greg B
GB
Levine
Edward A
EA
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced; D007078:Ileal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007263:Infusions, Parenteral; D007580:Jejunal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D010537:Peritoneum / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome