Peritoneal Carcinomatosis from Adenocarcinoma of the Colon
- 1 June 1996
- journal article
- review article
- Published by Wiley in World Journal of Surgery
- Vol. 20 (5), 585-592
- https://doi.org/10.1007/s002689900091
Abstract
Peritoneal carcinomatosis is a major cause of surgical treatment failure in patients with colorectal cancer. In the past patients with this condition have had a lethal outcome. In this study, 64 consecutive patients were treated by the cytoreductive approach, which involved surgery to maximally resect all cancer in the abdomen and pelvis, early postoperative intraperitoneal chemotherapy with 5-fluorouracil (5-FU) and mitomycin C, and three cycles of adjuvant intraperitoneal 5-FU with systemic mitomycin C. The clinical features that may affect prognosis were assessed and critically analyzed statistically. Peritoneal implant size of < 5 cm present in the abdomen and pelvis at the time of exploration correlated with a good prognosis (p < 0.0001), as did complete cytoreduction with tumor removed to nodules < 2.5 mm (p < 0.0001). Involvement of only one or two of the five abdominopelvic regions, compared to three or more regions, was a significant determinant of prognosis (p < 0.0001). Finally, a mucinous histologic type correlated adversely with prognosis when compared to intestinal-type adenocarcinomas (p < 0.001). These data suggest that patients with small-volume peritoneal seeding from colon cancer should be treated with cytoreductive surgery and aggressive regional and systemic chemotherapy in an attempt to achieve long-term disease-free survival.Keywords
This publication has 29 references indexed in Scilit:
- Prognostic Features of 51 Colorectal and 130 Appendiceal Cancer Patients with Peritoneal Carcinomatosis Treated by Cytoreductive Surgery and Intraperitoneal ChemotherapyAnnals of Surgery, 1995
- Peritonectomy ProceduresAnnals of Surgery, 1995
- Dissection by electrocautery with a ball tipJournal of Surgical Oncology, 1994
- Pseudomyxoma Peritonei A Cancer Whose Biology Is Characterized by a Redistribution PhenomenonAnnals of Surgery, 1994
- Peritoneal carcinomatosis from appendiceal cancerDiseases of the Colon & Rectum, 1993
- Intraperitoneal hyperthermic treatment for peritoneal dissemination of colorectal cancersDiseases of the Colon & Rectum, 1992
- Hyperthermo‐chemotherapy combined with cytoreductive surgery for the treatment of gastric cancer with peritoneal disseminationWorld Journal of Surgery, 1991
- Histologic changes induced by intraperitoneal chemotherapy with 5-fluorouracil and mitomycin c in patients with peritoneal carcinomatosis from cystadenocarcinoma of the colon or appendixCancer, 1990
- Intraperitoneal Hyperthermic Perfusion Combined with Surgery Effective for Gastric Cancer Patients with Peritoneal SeedingAnnals of Surgery, 1988
- Malignant pseudomyxoma peritonei of colonic originDiseases of the Colon & Rectum, 1987