Abdominal cancer with peritoneal carcinomatosis treated by peritonectomy procedure and intraperitoneal chemohyperthermia

The aim of this study was to estimate the results of a phase I-II prospecti ve study in which peritoneal carcinomatosis was managed with Peritonectomy Procedure (PP) associated with Intraperitoneal Chemohyperthermia (IPCH). Methods: Twenty two patients were included for peritoneal carcinomatosis fr om colorectal cancer (14), ovarian cancer (2), peritoneal malignant mesothe lioma (2), gallbladder cancer (1), gastric cancer (1), appendiceal cancer ( 1) and peritoneal pseudomyxoma (1). Peritoneal carcinomatosis was mainly ad vanced disease (19 stage 3 and 4, 2 stage 2, 1 stage 1). All the patients u nderwent surgical resection of their primacy tumor with PP as described by Sugarbaker and IPCH (with mitomycine C, cisplatinium or both). IPCH used in this. study was a "closed sterile circuit" device wit-h inflow temperature s ranging from 46 to 48 degrees C. IPCH was performed on the same day as PP (12/22) or delayed (10/22). Results: Significant down staging of peritoneal carcinomatosis was achieved for 18 patients. One patient died postoperatively while morbidity rate was 7/22 (2 long postoperative ileus, 2 grade 3 leucopenia, 2 anastomotic leak age and 1 biliary fistula). Conclusions: PP combined with immediate IPCH is an aggressive treatment. De spite a high morbidity, this association appears to be an effective therapy in peritoneal carcinomatosis. Larger phase III studies are now needed to d emonstrate its efficacy on long-term survival.