Multimodal treatment of peritoneal malignancies - results of the implantation in a tertiary hospital

• Published in: Journal of Coloproctology 2012-06, Vol.32 (2), p.106-112
• Main Authors: Rabelo, Fernanda Elias Ferreira, Queiroz, Fábio Lopes de, Rego, Rodrigo Soares Napoleão do, Costa, Breno Xaia Martins da, Lamounier, Paulo Cesar de Carvalho, Oliveira, Teon Augusto Noronha de, Lacerda Filho, Antônio, Paiva, Rodrigo de Almeida
• Format: Article
• Language: English
• Subjects: cirurgia; colorectal cancer; câncer colorretal; drug therapy; GASTROENTEROLOGY & HEPATOLOGY; peritoneum; peritônio; pseudomixoma peritoneal; pseudomyxoma peritonei; quimioterapia; SURGERY
• ISSN: 2317-6423; 2237-9363; 2317-6423
• DOI: 10.1590/S2237-93632012000200002

INTRODUCTION: Peritoneal carcinomatosis is a condition that may be present in the natural history of colorectal cancer and some other tumors, such as pseudomyxoma peritonei. It has been associated with poor prognosis. The treatment for patients with this condition, up until recently, was systemic chemotherapy or palliative care to relieve the pain and suffering caused by peritoneal dissemination of certain cancers. Promising results, however, have been reported after the implementation of radical cytoreductive surgery followed by peroperative hyperthermic intraperitoneal chemotherapy. OBJECTIVE: To evaluate the results of cytoreductive surgery and peroperative hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal carcinomatosis secondary to colorectal cancer and pseudomyxoma peritonei. RESULTS: We retrospectively evaluated 24 patients from 2004 to 2011. Mean age was 51.31 years, and 54% were female. The primary diagnosis in 50.01% of the cases was pseudomyxoma peritonei, 41.66%, of colon cancer, and 8.33%, of mesothelioma. The overall complication rate was around 83%, two patients (8%) subsequently died between the 8th and 30th postoperative day. There was an association between the peritoneal carcinomatosis index (PCI) and operative time. The one-year survival rate in the group examined was 60% for colon cancer, and 78.5% for pseudomyxoma. Overall survival was 50% in three years. CONCLUSION: cytoreductive surgery combined with HIPEC is a treatment option for patients with peritoneal carcinomatosis of colorectal origin and pseudomyxoma. Despite the high rate of peroperative complications (83%), it was possible to achieve a superior survival rate in relation to conventional treatments reported in the literature.