Complications and tolerance of heated intraperitoneal chemotherapy and cytoreductive surgery for peritoneal carcinomatosis: results of a phase I-II study of peritoneal carcinomatosis from different sources

Peritoneal carcinomatosis represents the terminal stage of adenocarcinomas of the gastrointestinal tract. A new treatment combining cytoreductive surg ery and intraperitoneal chemotherapy-hyperthermia has been used with encour aging results. The purpose of this study was to report the complications as sociated with this treatment Fourty procedures were carry out in 37 patient s. Death occurred in 3 patients. Major medical complications were 13 pulmon ary infections, II acute renal failure (with only 3 who needed dialysis) an d 10 patients with neutropenia grade 3 and 4 toxicity. Intra-abdominal comp lications occurred in 16 patients (there were II anastomotic leak and/or bo wel perforation, and 12 intra-abdominal infections). Some complications lik e secretory, diarrhea or tubulopathia which were related to these treatment need further investigations. Six procedures were without any complications , 6 presented minor ones and 22 major complications. Adverse effects were r elatively important with this new treatment strategy. This was maybe due to a learning process; there is no death and only one anastomotic leak in our last study including 30 patients with cytoreductive surgery and intraperit oneal chemotherapy-hyperthermia.