[Peritoneal carcinomatosis. Ten years of applying the new combined triple therapy. Personal experience].
BACKGROUND
Peritoneal carcinomatosis is the main problem in treating patients with advanced cancer; in addition to the lack demonstrably effective treatment, once diagnosed, this condition leads inexorably and rapidly to death. There is no response to traditional systemic treatments and the mean survival is less than 12 months after diagnosis. The application of a new combined triple therapy consisting of cytoreductive surgery together with perioperative intraperitoneal chemotherapy and heated intraoperative intraperitoneal chemotherapy followed by early post-operative intra-abdominal chemotherapy is providing good results, even occasionally with curative intent, which suggests a new alternative treatment strategy.


METHODS
We present our experience of a series of 110 cytoreductions carried out by the author in 71 patients between February 14, 1997 and February 14, 2007.


RESULTS
In our series with a mean follow-up of 42 months, 42% of the patients survived for more 18 months after treatment, 37% for over 2 years, 20 % for more than 3 years, and 12.6% for over 5 years. Long-term survival was achieved among patients treated for persistent diffuse carcinomatosis secondary to pseudomyxoma, ovarian carcinomatosis, primary malignant peritoneal mesotheliomas, and colon carcinomatosis.


CONCLUSIONS
The introduction and implementation of this new triple treatment strategy in Spain constitutes the best therapeutic alternative for these unfortunate patients. In our experience, we were able to achieve an initial control of the disease in 83% of our patients, medium-term survival (3 years) in 20% and long-term survival in 12.5% in four of the disease entities included in our protocol for the treatment of carcinomatosis.
Programa de Carcinomatosis Peritoneal, Policlínica San José, Vitoria-Gasteiz, Alava, España. agomezpor@teleline.es
Alberto
A
Gómez Portilla
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D011446:Prospective Studies