[Intraoperative therapeutic intensification techniques in locally advanced abdominal sarcomas].
BACKGROUND
Sarcomas are rare tumors that develop from mesenchymal cells. Their management is difficult due to their changing histology, location, and behavior. In this article, we discuss the use of two intraoperative therapeutic intensification techniques, intraoperative radiotherapy (IORT) and hyperthermic intraoperative intraperitoneal chemotherapy (HIIC), in the treatment of locally advanced abdominal sarcomas and peritoneal sarcomatosis.


METHODS
We analyzed a series of 20 consecutive patients diagnosed with advanced abdominal sarcoma and 5 patients with a diagnosis of peritoneal sarcomatosis who were evaluated and treated in our department from December 1996 to October 2005. In advanced abdominal sarcoma, we performed complete or maximal resection followed by IORT. In peritoneal sarcomatosis we performed massive cytoreduction followed by HIIC.


RESULTS
The survival rate in advanced abdominal sarcomas without sarcomatosis was 65% at 26 months. Among the 5 patients diagnosed with peritoneal sarcomatosis, 3 were alive, and 2 were without recurrence at 20 months of follow-up.


CONCLUSIONS
IORT associated with radical surgery seems to improve local control and survival in advanced abdominal sarcomas. Maximal cytoreduction plus HIIC used as treatment of peritoneal sarcomatosis is a feasible technique that offers a therapeutic option with curative intent.
García Sabrido
José Luis
JL
Servicio de Cirugía General y del Aparato Digestivo, Universidad Complutense, Hospital General Universitario Gregorio Marañón. Madrid, España.
Velasco Sánchez
Enrique
E
Calvo
Felipe
F
Gómez Lanz
Laura
L
Sánchez Tocino
Juan María
JM
Argudo Garijo
Salvador
S
Ruiz Gómez
Francisco
F
Rodríguez-Bachiller
Luis
L
González Bayón
Luis
L
Valdecantos Montes
Eladio
E
Pérez Ferreiroa
Julio
J
D000008:Abdominal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D007430:Intraoperative Care / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome