Peritonectomy combined with intraperitoneal chemohyperthermia in abdominal cancer with peritoneal carcinomatosis: phase I-II study

• Published in: Anticancer research Vol. 19; no. 3B; p. 2317
• Main Authors: Gilly, F N, Beaujard, A, Glehen, O, Grandclement, E, Caillot, J L, Francois, Y, Sadeghi-Looyeh, B, Gueugniaud, P Y, Garbit, F, Benoit, M, Bienvenu, J, Vignal, J
• Format: Journal Article
• Language: English
• Published: Greece 01.05.1999
• Subjects: Abdominal Neoplasms - mortality; Abdominal Neoplasms - secondary; Abdominal Neoplasms - surgery; Abdominal Neoplasms - therapy; Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cisplatin - therapeutic use; Combined Modality Therapy; Digestive System Neoplasms - mortality; Digestive System Neoplasms - pathology; Digestive System Neoplasms - therapy; Female; Humans; Hyperthermia, Induced - adverse effects; Mesothelioma - mortality; Mesothelioma - pathology; Mesothelioma - surgery; Mesothelioma - therapy; Middle Aged; Mitomycin - administration & dosage; Mitomycin - adverse effects; Mitomycin - therapeutic use; Neoplasm Staging; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Patient Selection; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - secondary; Peritoneal Neoplasms - surgery; Peritoneal Neoplasms - therapy; Survival Rate; Time Factors
• ISSN: 0250-7005

To evaluate the feasibility and the tolerance of Peritonectomy Procedure (PP) combined with Intraperitoneal Chemohyperthermia (IPCH) in patients with peritoneal carcinomatosis, a phase I-II study has been realised from January 1997 to September 1998. Eighteen patients were included for peritoneal carcinomatosis from colorectal cancer (13), ovarian cancer (2), gallbladder cancer (1), gastric cancer (1) and peritoneal mesothelioma (1). Peritoneal carcinomatosis were mainly advanced disease (16 stage 3 and 4, 2 stage 2). All the patients underwent surgical resection of their primary 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). Significant down-staging of peritoneal carcinomatosis was achieved for 16 patients. One patient died postoperatively, while the morbidity rate was 6/18 (long postoperative ileus, grade 3 leucopenia and anastomotic leakage). Combination of PP and IPCH could achieve significant tumoral volume reduction in peritoneal carcinomatosis. This aggressive treatment must be employed selectively because of its morbidity. Larger phase III studies are now needed.