Cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma.
BACKGROUND
Small bowel adenocarcinoma is a rare malignancy that presents both a diagnostic and therapeutic challenge. The late presentation is often associated with disseminated carcinomatosis which is regarded a terminal event. We review our experience with small bowel peritoneal carcinomatosis following treatment with cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC).


METHODS
From a prospective database of CRS and PIC, seven patients were identified to have undergone treatment for small bowel peritoneal carcinomatosis with CRS and hyperthermic intraperitoneal chemotherapy (Mitomycin C) and early postoperative intraperitoneal chemotherapy (5FU). A retrospective review was undertaken to describe the clinicopathological characteristics and survival outcomes.


RESULTS
The median follow-up was 17 months (range, 5-46 months). Six of seven patients have died. The disease-free survival was 12 months and the overall median survival was 25 months. The 1-, 2-, and 3-year survivals were 57%, 38%, and 20% respectively. Tumor histology of poorly differentiated adenocarcinoma with signet ring, lymphovascular invasion and perineural invasion appeared to be associated with a poor outcome.


CONCLUSIONS
Cytoreductive surgery and perioperative intraperitoneal chemotherapy is a treatment option for small bowel cancer peritoneal carcinomatosis with encouraging survival results.
Chua
Terence C
TC
Department of Surgery, University of New South Wales, St George Hospital, Kogarah, NSW, Sydney, Australia.
Koh
Ju-Li
JL
Yan
Tristan D
TD
Liauw
Winston
W
Morris
David L
DL
D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007078:Ileal Neoplasms / Q000401:mortality / Q000628:therapy*; D007580:Jejunal Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies