Surgical treatment of peritoneal carcinomatosis with reduction surgery and perioperative chemotherapy

La Revue du Praticien. 2008 May 15;58(9):940-3. [Link]

Zinzindohoué F, Glehen O, Ferraz JM, Gilly F, Cuqnenc PH.

Service de chirurgie digestive, générale et oncologique, Hôpital Européen Georges-Pompidou, 75908 Paris. franck.zinzindohoue@egp.aphp.fr

Abstract

So far, peritoneal carcinomatosis had been considered as the last progression stage of intra-abdominal cancers, and thus without any therapeutic recourse. During the last ten years, the association of tumour surgical resection and perioperative intraperitoneal chemotherapy (with or without hyperthermia) has proven to produce long term survival and even cure. This aggressive therapeutic strategy is associated with mortality and morbidity, which add to the mortality and morbidity of surgery and chemotherapy. It thus requires a careful patient selection conducted by specialized multidisciplinary teams. The main indications are peritoneal carcinomatosis on colorectal cancer, stomach cancer, ovarian cancer, pseudomyxoma and mesothelioma. The treatment can also be initiated secondarily, if carcinomatosis is detected during a procedure performed in a center where this type of treatment is not provided. An organ resection should thus be performed. The patient is then referred to a specialized center, either within the ten days following the procedure, or after three months, most of the time after an adjuvant therapy.