Peritonectomy combined with intraperitoneal chemohyperthermia in abdominalcancer with peritoneal carcinomatosis: Phase I-II study

Objective: To evaluate the feasability and the tolerance of Peritonectomy P rocedure (PP) combined with Intraperitoneal Chemohyperthermia (IPCH) in pat ients with peritoneal carcinomatosis, a phase I-II study has been realised fi om January 1997 to September 1998. Methods: Eigtheen patients were inclu ded for peritoneal carcinomatosis from colrectal cancer (13), ovarian cance r (2) gallbladder cancer (1), gastric cancer (I) and peritoneal mesotheliom a (I). Peritoneal carcinomatosis were mainly advanced disease (16 stage 3 a nd 4, 2 stage 2). All the patients underwent surgical resection of their pr imary tumor with PP as described by Sugarbaker and IPCH (with Mitomycin C, Cisplatinum or both). IPCH used in this study was a "closed sterile circuit " device with inflow temperatures ranging from 46 to 48 degrees C. IPCH was performed on the same day as PP (8118) or delayed (10/18). Results: Signif icant down-staging of peritoneal carcinomatosis was achieved for 16 patient s. One patient died postoperatively, while the morbidity rate was 6/18 (lon g postoperative ileus, grade 3 leucopenia and anastomotic leakage). Conclus ions: Combination of PP and IPCH could achieve significant tumoral volume r eduction in peritoneal carcinomatosis. This aggressive treatment must be em ployed selectively because of its morbidity. Larger phase III studies are n ow needed.