Pelvic peritonectomy without intraperitoneal chemotherapy for localized peritoneal carcinomatosis.
Academic Article
Overview
abstract
AIM: This study assessed the feasibility of pelvic peritonectomy for carcinomatosis localized in the pelvic cavity. The survival and clinical benefits were examined, especially in colorectal cancer. PATIENTS AND METHODS: Seventeen patients underwent pelvic peritoneal resection for peritoneal dissemination localized in the pelvis (10 colorectal, six ovarian, one cervical cancer). The male/female ratio was 5/12. The age range was 31-83 (median=63) years. The peritoneal cancer index was 2-16 (median=4). Perioperative intraperitoneal chemotherapy was not performed. RESULTS: For all 17 cases, pelvic exenteration significantly increased invasiveness in the treatment of pelvic peritoneal carcinomatosis (p<0.05). Additionally, pelvic exenteration did not improve prognosis. In all cases, the serum carcinoembryonic antigen (CEA) levels decreased significantly from a mean of 15.1 (range=0.8-55.7) to 2.4 (range= 0.5-7.4) ng/ml (paired t-test, p<0.05). For colorectal cancer, serum CEA decreased significantly from 19.3 (range=1.2-55.7) to 2.7 (range=0.5-7.4) ng/ml (paired t-test, p<0.05). In the colorectal cancer series, cumulative 1- and 3-year overall survival rates were 89% and 71%, respectively. One- and 3-year recurrence-free survival rates were 78% and 67%, respectively. CONCLUSION: The cytoreductive effect of this method is feasible and excellent for pelvic carcinomatosis. Pelvic peritonectomy without perioperative intraperitoneal chemotherapy is a safe, effective procedure for peritoneal carcinomatosis from colorectal cancer localized in the pelvis.
