[Intraoperative and early postoperative intraperitoneal chemotherapy--adjuvant treatment for locally advanced digestive system cancer].

Abstract

UNLABELLED:

Surgical treatment for locally advanced digestive cancers (invasion beyond the serosa, adjacent structures penetration and perforated tumors) is followed by a high rate of peritoneal recurrence and distant metastasis. Simultaneous intraperitoneal chemotherapy with surgical resection, which is continued over the early postoperative period act on the tumor cells which can be mobilized during the surgical dissection. This adjuvant treatment could lead to better control of local recurrence. Moreover, high levels of the agents are reached in the portal circulation which could be profitable for preventing hepatic metastasis. The main drawback of the method is represented by the impaired immunologic activity of the peritoneum, which can cause, at least theoretically, detrimental complications.

OBJECTIVE:

The efficiency of the intraoperative and early postoperative intraperitoneal chemotherapy is the subject of a prospective randomized study, started 8 months ago in our department.

METHOD:

Patients with locally advanced (penetration of the tumor beyond serosal layer, without liver metastasis) are randomized for adjuvant intraperitoneal chemotherapy or standard treatment. Intraoperative chemotherapy is commenced after surgical resection but before accomplishing any anastomosis. We use 50 mg of cisplatinum for washing the peritoneal cavity and continue to instill 20 mg/m2 of cisplatinum intraperitoneally in the first four days after surgery. (8 patients were selected to be treated according to this protocol).

CONCLUSION:

Immediate postoperative outcome does not seem to be influenced by this treatment. The disease free interval and the overall survival rates can not be assessed at this moment of the study.

• Authors: Cr Bulat, M Stoian, S Pădureanu, L Bîşcă, Oana Blănaru
• Journal: Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi (Rev Med Chir Soc Med Nat Iasi) 2004 Apr-Jun Vol. 108 Issue 2 Pg. 403-8 ISSN: 0048-7848 [Print] Romania
• Vernacular Title: Chimioterapia intraperitoneală intra şi postoperatorie--tratament adjuvant pentru cancerele digestive local avansate.
• PMID: 15688822 (Publication Type: Clinical Trial, English Abstract, Journal Article, Randomized Controlled Trial)

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Aged
• Antineoplastic Agents (administration & dosage)
• Carcinoma (drug therapy, secondary, surgery)
• Chemotherapy, Adjuvant (methods)
• Cisplatin (administration & dosage)
• Digestive System Neoplasms (drug therapy, surgery)
• Female
• Humans
• Instillation, Drug
• Intraoperative Period
• Male
• Middle Aged
• Neoplasm Staging
• Peritoneal Lavage
• Peritoneal Neoplasms (drug therapy, secondary, surgery)
• Postoperative Period
• Prospective Studies
• Treatment Outcome