title: Cytoreductive surgery and intraoperative intraperitoneal hyperthermic chemotherapy in patients with peritoneal carcinomatosis of colorectal origin.
abstract: The median survival in patients with peritoneal carcinomatosis from colorectal adenocarcinoma is,with conventional approaches, only about six months. Combined treatment consisting of maxi-mum cytoreductive surgery plus intraoperative intraperitoneal hyperthermic chemotherapy has been shown, albeit in small non-comparative series, to increase disease-free survival and overall survival, compared with previous series. Further, a randomized trial has demonstrated better results (a median survival of 22.4 months) with cytoreduction plus intraperitoneal chemotherapy compared with conventional chemotherapy. Technical considerations, infrastructure requirements and possible complications imply specialized centres and staff. Surgery consists of peritonectomy of affected areas and fulguration of all macroscopic lesions. Intraperitoneal chemotherapy must reach all parts of the peritoneal cavity and the temperature of the hyperthermic procedure must be maintained between 42-44 degrees C. Three prognostic factors associated with this procedure are: pathologic tumour grade, peritoneal carcinomatosis index, and cytoreductive surgery grade.
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Regional Universitario de Málaga Carlos Haya, Málaga, Spain. cprptot@hotmail.com
authors.forename: César P
authors.initials: CP
authors.lastname: Ramírez Plaza
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Cobo Dols
authors.forename: Alberto
authors.initials: A
authors.lastname: Gómez Portilla
authors.forename: Agustín
authors.initials: A
authors.lastname: de la Fuente Perucho
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D006979:Hyperthermia, Induced; D007432:Intraoperative Period; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents