Treatment of Peritoneal Carcinomatosis by Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemoperfusion (IHCP): Postoperative Outcome and Risk Factors for Morbidity

Roviello, Franco; Marrelli, Daniele; Neri, Alessandro; Cerretani, Daniela; Manzoni, Giovanni; Pedrazzani, Corrado; Cioppa, Tommaso; Nastri, Giacomo; Giorgi, Giorgio; Pinto, Enrico
November 2006
World Journal of Surgery;Nov2006, Vol. 30 Issue 11, p2033
Academic Journal
Cytoreductive surgery with limited or extended peritonectomy associated with intraperitoneal hyperthermic chemoperfusion (IHCP) has been proposed for treatment of peritoneal carcinomatosis (PC) from abdominal neoplasms. Fifty-nine patients with PC from abdominal neoplasms underwent 61 treatments using this technique from January 2000 to August 2005. Surgical debulking, completed by partial or total peritonectomy, was performed in most cases. In 16 patients with positive peritoneal cytology without macroscopic peritoneal disease, IHCP was performed in order to prevent peritoneal recurrence. IHCP was carried out throughout the abdominopelvic cavity for 60 minutes using a closed abdomen technique. Intra-abdominal temperature ranged between 41°C and 43°C; mitomycin C (25 mg/mq) and cisplatin (100 mg/mq) were the anticancer drugs generally used, and they were administered with a flow rate of 700–800 ml/minute. Mean hospital stay was 13 ± 7 (range 7–49) days. Postoperative complications occurred in 27 patients (44.3%); of these, major morbidity was observed in 17 (27.9%). The most frequent complications were wound infection (9 cases), grade 2 or greater hematological toxicity (5 cases), intestinal fistula (5 cases), and pleural effusion requiring drainage (5 cases). Reoperation was necessary in 5 patients (8.2%). One patient with multiorgan failure died in the postoperative period (mortality rate: 1.6%). Multivariate analysis of several variables identified completeness of cancer resection (CCR-2/3 vs. CCR-0/1, relative risk: 9.27) and age (relative risk: 1.06 per year) as independent predictors of postoperative morbidity. Preliminary follow-up data indicate that survival probability may be high in patients with ovarian or colorectal cancer and low in patients with gastric cancer. IHCP combined with cytoreductive surgery involves a high risk of morbidity, but postoperative complications could be resolved favorably in most cases with correct patient selection and adequate postoperative care. Tumor residual and advanced age significantly increase the risk of morbidity after this procedure.


Related Articles

  • Topical chemo aids tumor fight. Sabbagh, Leslie // Ophthalmology Times;2/13/95, Vol. 20 Issue 7, p1 

    Reports on the effectivity of the use of mitomycin C, a topical chemotherapy for conjunctival tumors. Suppression of cryotherapy induced conjunctival adhesions; Adverse effects.

  • Chemoradiation for carcinoma of the anal canal.  // British Journal of Hospital Medicine (17508460);May2008, Vol. 69 Issue 5, p301 

    The article focuses on the study that compared the efficacy of cisplatin-based therapy versus mitomycin-based therapy in treatment of anal canal carcinoma. The study was a controlled trial using different approach in 682 patient, the result concluded that in the population of patients...

  • Mitomycin C as an adjunct in the treatment of localised ocular surface squamous neoplasia. Chen C; Louis D; Dodd T; Muecke J // British Journal of Ophthalmology;Jan2004, Vol. 88 Issue 1, p17 

    AIM: To report the outcome of topical mitomycin C (MMC) used as adjunctive treatment following primary excision of ocular surface squamous neoplasia (OSSN). METHOD: Prospective, non-comparative interventional case series of 27 primary OSSN lesions from 26 patients treated in a single ocular...

  • Cisplatin/dacarbazine/doxorubicin.  // Reactions Weekly;4/24/2010, Issue 1298, p13 

    The article describes the case of a 44-year-old man who acquired tumour lysis syndrome while undergoing treatment with cisplatin, dacarbazine and doxorubicin.

  • Chronic Administration of Single Weekly Paclitaxel in Heavily Pretreated Ovarian Cancer Patients. Yamamoto, Kenji; Oogi, Shirei; Inoue, Hiromi; Kudoh, Kazuya; Kita, Tsunekazu; Kikuchi, Yoshihiro // Current Medicinal Chemistry;Feb2004, Vol. 11 Issue 4, p425 

    Ovarian cancer patients with paclitaxel-resistance have been reported to respond to a weekly schedule of the same drug. In this report, two cases with long progression free interval by weekly paclitaxel (T) are presented. Case 1. A 41-year-old Japanese woman, gravida 2, para 0, was referred to...

  • Synthesis, characterization and biological evaluation of Tc-labeled Mitomycin C. Bokhari, Tanveer; Akbar, Muhammad; Roohi, Samina; Hina, Saira; Sohaib, Muhammad; Rizvi, Faheem // Journal of Radioanalytical & Nuclear Chemistry;Mar2015, Vol. 303 Issue 3, p1779 

    Mitomycin-C is used for the treatment of different types of tumours. In present work, a reliable method was developed for radiolabeling of Mitomycin-C with Tc for diagnostic purpose. Tc-Mitomycin-C was obtained with radiochemical yield of 100 % by adding 200 µg Mitomycin-C, 1 mL (15 mCi) of...

  • Neoadjuvant topical mitomycin C chemotherapy for conjunctival and corneal intraepithelial neoplasia. Singh, A. D.; Jacques, R.; Rundle, P. A.; Rennie, I. G.; Mudhar, H. S.; Slater, D. // Eye;Sep2006, Vol. 20 Issue 9, p1092 

    The article discusses the clinical treatment of conjunctival and corneal intraepithelial neoplasia by the use of neoadjuvant topical mitomycin C chemotherapy, double freeze thaw cryotherapy, and excision of the residual conjunctival tumor. A case study of 68-year-old male with redness of right...

  • Cisplatin (Platinol, Platinol-AQ).  // Oncology Nurse Advisor;Jan/Feb2011, Vol. 2 Issue 1, p33 

    No abstract available.

  • Cisplatin, Vinblastine, and Bleomycin in Advanced and Recurrent Ovarian Germ--Cell Tumors. Williams, Stephen D.; Blessing, John A.; Moore, David H.; Homesley, Howard D.; Adcock, Leon // Annals of Internal Medicine;7/1/89, Vol. 111 Issue 1, p22 

    Presents a study which evaluated the efficacy of cisplatin-based combination chemotherapy in patients with advanced ovarian germ-cell tumors. Description of the demographic and clinical characteristics of the patients; Likelihood of survival in patients with established metastatic disease;...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics