SURGICALLY DOCUMENTED RESPONSES TO PACLITAXEL AND CISPLATIN IN PATIENTS WITH PRIMARY PERITONEAL CARCINOMA

Intra-abdominal carcinomatosis indistinguishable from ovarian cancer m ay occur after removal of the ovaries or in association with surface o varian involvement. Because its histologic pattern and behavior approx imate those of ovarian cancer, this entity, known as primary peritonea l carcinoma, has been treated in a similar fashion-cytoreductive surge ry followed by systemic chemotherapy. This review was undertaken to as sess the efficacy of combination chemotherapy with paclitaxel and cisp latin, the current front-line chemotherapeutic regimen for ovarian can cer, in patients with primary peritoneal carcinoma, Sixteen patients d iagnosed between January 1989 and July 1994 with primary peritoneal ca rcinoma were treated at the Hospital of the University of Pennsylvania , The records of the three patients whose initial chemotherapeutic reg imen included paclitaxel and cisplatin were reviewed. An additional ca se from the Robert Wood Johnson Medical Center, Camden, New Jersey, wa s included, Pathologic review of all cases was conducted at the time o f clinical management and again as part of this study. Reassessment la parotomy was performed in all patients after the completion of chemoth erapy, Complete clinical information was available on all patients, Al l four patients presented with intra-abdominal carcinomatosis, and lar ge volume(>1 cm) residual disease was present following initial cytore duction, Following chemotherapy, second-look laparotomy documented one complete pathologic response and three partial (>50% tumor volume red uction), but marked, responses, Combination chemotherapy with paclitax el and cisplatin produces surgically documented responses in patients with primary peritoneal carcinoma. (C) 1996 Academic Press, Inc.