Palliative effects of an incomplete cytoreduction combined with perioperative intraperitoneal chemotherapy.

Abstract

OBJECTIVES:

Incomplete cytoreduction often occurs because of overwhelming burden of disease intraperitoneally that limit a successful cytoreduction. The outcome of an incomplete cytoreduction followed by administering perioperative intraperitoneal chemotherapy on whether it prolongs survival or palliates symptoms is yet to be established.

METHODS:

A retrospective review of a prospectively collected database was performed. Eleven patients were identified to have had an incomplete (CC2/3) cytoreduction and received either hyperthermic intraperitoneal chemotherapy or early postoperative intraperitoneal chemotherapy. The symptoms of the patients before and after treatment during follow-up consultations in clinic were noted. Survival analysis was performed using the Kaplan Meier method.

RESULTS:

The median follow-up period was 19 (range, 0.5-35) months. The overall median survival was 21 months with a 1- and 2-year survival rate of 72% and 36%, respectively. Five of 7 patients with pseudomyxoma peritonei and 2 of 3 patients with colorectal cancer peritoneal carcinomatosis experienced symptom improvement after treatment. Severe postoperative morbidity and achieving symptomatic improvement following treatment seems to be associated with a dismal prognosis.

CONCLUSION:

Our results suggest that some patients derive a survival and symptomatic benefits despite an incomplete cytoreductive surgery and perioperative intraperitoneal chemotherapy. The effects of this treatment require further investigation to determine its benefits as a palliative procedure.

• Authors: Terence C Chua, Bilal Baker, Tristan D Yan, Jing Zhao, David L Morris
• Journal: American journal of clinical oncology (Am J Clin Oncol) Vol. 33 Issue 6 Pg. 568-71 (Dec 2010) ISSN: 1537-453X [Electronic] United States
• PMID: 20019578 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (administration & dosage)
• Carcinoma (mortality, pathology, therapy)
• Cohort Studies
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Infusions, Parenteral
• Kaplan-Meier Estimate
• Laparotomy (methods)
• Male
• Neoplasm Invasiveness
• Neoplasm Staging
• Palliative Care
• Perioperative Care
• Peritoneal Neoplasms (mortality, pathology, therapy)
• Retrospective Studies
• Risk Assessment
• Survival Analysis
• Treatment Outcome