Surgery in Multimodal Treatment of Cancer: Peritoneal Carcinomatosis

  • Angelo Di Giorgio
  • Fabio Accarpio
  • Simone Sibio
  • Daniele Biacchi
  • Sergio Gazzanelli
  • Anna M. Baccheschi
  • Tommaso Cornali
  • Marisa Di Seri
  • Linda Cerbone
  • Paolo Sammartino
Part of the Updates in Surgery book series (UPDATESSURG)


Until recent years a diagnosis of peritoneal carcinomatosis (PC) from intra-abdominal solid tumors carried a uniformly fatal prognosis, often within weeks or months. Since the 1980s, following the intuition of an American surgeon, Paul Sugarbaker, combined treatment modalities of PC have developed considerably. Since the first pioneering approaches on the treatment of “pseudomyxoma peritonei”


Peritoneal Carcinomatosis Cytoreductive Surgery Intraperitoneal Chemotherapy Peritoneal Cancer Index Pseudomyxoma Peritonei 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Sugarbaker PH (1994) Pseudomyxoma peritonei. A cancer whose biology is characterized by a redistribution phenomenon Ann Surg 219:109–111PubMedGoogle Scholar
  2. 2.
    Yan TD, Black D, Savady R et al (2006) A systematic review on the efficacy of cytoreductive surgery and perioperative intraperitoneal chemotherapy for pseudomyxoma peritonei. Ann Surg Oncol 14:484–492PubMedCrossRefGoogle Scholar
  3. 3.
    Ghelen O, Kwiatowsky F, Sugarbaker P.H. et al. Cytoreductive surgery combined with perioperative intraperineal chemotherapy for the management of peritoneal carcinomatosis for colorectal cancer: a multi-istitutional study. J Clin Oncol; 2004, 22:3284–3292CrossRefGoogle Scholar
  4. 4.
    Di Giorgio A, Naticchioni E, Biacchi D et al (2008) Cytoreductive surgery (peritonectomy procedures) combined with hipertermic intraperitoneal chemotherapy (HIPEC) in the treatment of diffuse peritoneal carcinomatosis from ovarian cancer. Cancer 113:315–325PubMedCrossRefGoogle Scholar
  5. 5.
    Yan TD, Brun EA, Cerruto CA et al (2006) Prognostic indicators for patients undergoing cytoreductive surgery and perioperative intraperitoneal chemotherapy for diffuse malignant peritoneal mesotelioma. Ann Surg Oncol 14:41–49PubMedCrossRefGoogle Scholar
  6. 6.
    Esquivel J (2005) Multidisciplinary sequencial therapy for the treatment of peritoneal surface malignancy of colorectal origin: a plea for cooperation between medical and surgical oncologists. Ann Surg Oncol 12:950–951PubMedCrossRefGoogle Scholar
  7. 7.
    Sugarbaker PH, Hughes KA (1993) Surgery for colorectal metastasis to liver. In: Wanebo H (ed) Colorectal cancer. Mosby-Year Book, St. Louis, pp 405–413Google Scholar
  8. 8.
    Sugarbaker PH (1996) Peritoneal carcinomatosis: principle of management. Kluwer, BostonGoogle Scholar
  9. 9.
    Sugarbaker PH (1995) Peritonectomy procedures. Ann Surg 221:29–42PubMedGoogle Scholar
  10. 10.
    De Lima Vasquez V, Sugarbaker PH (2003) Total anterior parietal peritonectomy. J Surg Oncol 83:261–263CrossRefGoogle Scholar
  11. 11.
    De Lima Vasquez V, Sugarbaker PH (2003) Cholecystectomy lesser omentectomy and stripping of the omental bursa: a peritonectomy procedure. J Surg Oncol 84:45–49CrossRefGoogle Scholar
  12. 12.
    Elias DM, Ouellet JF (2001) Intraperitoneal chemohyperthermia. Rationale, technique, indications and results. Surg Oncol Clin N Am 10:915–933PubMedGoogle Scholar
  13. 13.
    Yan TD, Zappa L, Edwards G et al (2007) Perioperative outcomes of cytoreductive surgery and perioperative intraperitoneal chemotherapy for non-appendiceal peritoneal carcinomatosis from a prospective database. J Surg Oncol 96:102–112PubMedCrossRefGoogle Scholar
  14. 14.
    Kusamura S, Younan R, Baratti D et al (2006) Cytoreductive surgery followed by intraperitoneal hyperthermic perfusion. Cancer 106:1144–1153PubMedCrossRefGoogle Scholar
  15. 15.
    Jacquet P, Sugarbaker PH (1996) Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. In: Sugarbaker PH (ed) Peritoneal carcinomatosis: principle of management. Kluwer Academic, Boston, pp 359–374Google Scholar
  16. 16.
    Elias D, Blot F, El Otmany A et al (2001) Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy. Cancer 92:71–76PubMedCrossRefGoogle Scholar
  17. 17.
    Gomes Da Silva R, Sugarbaker PH (2006) Analysis of prognostic factors in seventy patients having a complete cytoreduction plus perioperative intraperitoneal chemotherapy for carcinomatosis from colorectal cancer. J Am Coll Surg 203:878–886CrossRefGoogle Scholar
  18. 18.
    Yan TD (2006) Preoperative workup. Proceedings of the 5th International Workshop on Peritoneal Surface Malignancy: December, 4th–6th 2006, Milan, pp 7–8Google Scholar
  19. 19.
    Ronett BM, Yan H, Kurman RJ et al (2001) Patients with pseudomyxoma peritonei associated with disseminated peritoneal adenomucinosis have a significantly more favorable prognosis than patients with peritoneal mucinous carcinomatosis. Cancer 92:85–91CrossRefGoogle Scholar
  20. 20.
    Raspagliesi F, Kusamura S, Campos Torres JC et al (2006) Cytoreduction combined with intraperitoneal hyperthermic perfusion chemotherapy in advanced/recurrent ovarian cancer patients: the experience of a National Cancer Institute of Milan. Eur J Surg Oncol 32:671–675PubMedCrossRefGoogle Scholar
  21. 21.
    Cotte E, Glehen O, Mohamed F et al (2007) Citoreductive surgery and intraperitoneal chemohyperthermia for chemoresistant and recurrent advanced epithelial ovarian cancer: prospective study of 81 patients. World J Surg 31:1813–1820PubMedCrossRefGoogle Scholar
  22. 22.
    Yan TD, Black D, Savady R et al (2006) Sistematic review on the efficacy of cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal carcinoma. J Clin Oncol 24:4011–4018PubMedCrossRefGoogle Scholar
  23. 23.
    Elias D, Raynard B, Farkhondeh F et al (2006) Peritoneal carcinomatosis of colorectal origin: long-term results of intraperitoneal chemohyperthermia with oxaliplatin following complete cytoreductive surgery. Gastroenterol Clin Biol 30:1200–1204PubMedCrossRefGoogle Scholar
  24. 24.
    Verwaal VJ, Van Ruth S, De Bree E et al (2003) Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol 21:3737–3743PubMedCrossRefGoogle Scholar
  25. 25.
    Esquivel J, Sticca R, Sugarbaker PH et al (2006) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Ann Surg Oncol 14:128–133PubMedGoogle Scholar
  26. 26.
    World Health Organization (1979) WHO handbook for reporting results of cancer treatment. WHO, GenevaGoogle Scholar
  27. 27.
    Bozzetti F, Braga M, Gianotti L et al (2001) Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: randomized multicentre trial. Lancet 358:1487–1492PubMedCrossRefGoogle Scholar
  28. 28.
    Reichman TW, Cracchiolo B, Sama J et al (2005) Cytoreductive surgery and intraoperative hyperthermic chemoperfusion for advanced ovarian carcinoma. J Surg Oncol 90:56–58CrossRefGoogle Scholar
  29. 29.
    Bijelic L, Yan TD, Sugarbaker PH (2007) Failure analysis of recurrent disease following complete cytoreduction and perioperative intraperitoneal chemotherapy in patients with peritoneal carcinomatosis from colorectal cancer. Ann Surg Oncol 14:2281–2288PubMedCrossRefGoogle Scholar
  30. 30.
    Lambert LA, Mansfield PF (2007) Cytoreductive surgery and perioperative peritoneal chemotherapy for colorectal carcinomatosis: if at first you don’t succeed... Ann Surg Oncol 14:3037–3039PubMedCrossRefGoogle Scholar
  31. 31.
    Magtibay PM, Adams PB, Silverman MB et al (2006) Splenectomy as part of cytoreductive surgery in ovarian cancer. Gynecol Oncol 102:369–374PubMedCrossRefGoogle Scholar
  32. 32.
    Merideth MA, Cliby WA, Keeney GL et al (2003) Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol Oncol 89:16–21PubMedCrossRefGoogle Scholar
  33. 33.
    Kianmanesh R, Scaringi S, Sabate JM et al (2007) Iterative cytoreductive surgery associated with hyperthermic intraperitoneal chemotherapy for treatment of peritoneal carcinomatosis of colorectal origin with or without liver metastases. Ann Surg 245:597–603PubMedCrossRefGoogle Scholar
  34. 34.
    Glehen O (2006) Hyperthermic intraoperative chemotherapy: nomenclature and modality of perfusion. Proceedings of the 5th International Workshop on Peritoneal Surface Malignancy: December, 4th–6th 2006, Milan, pp 17–18Google Scholar
  35. 35.
    Loggie BV, Fleming RA, Mc Quellon RP et al (2000) Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for disseminated cancer of gastrointestinal origin. Am Surg 66:561–568PubMedGoogle Scholar
  36. 36.
    Glehen O, Cotte E, Schreiber V et al (2004) Intraperitoneal chemohyperthermia and attempted cytoreductive surgery in patients with peritoneal carcinomatosis of colorectal origin. Br J Surg 91:747–754PubMedCrossRefGoogle Scholar
  37. 37.
    Milosevic MF, Fyles AV, Hill RP et al (1999) The relationship between elevated interstitial fluid pressure and blood flow in tumors: a bioengineering analysis. Int J Radiat Oncol Biol Phys 44:1111–1123CrossRefGoogle Scholar
  38. 38.
    Deraco M, Rossi CR, Pennacchioli E et al (2001) Cytoreductive surgery followed by intraperitoneal hyperthermic perfusion in the treatment of recurrent epithelial ovarian cancer: a phase II clinical study. Tumori 87:120–126PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Angelo Di Giorgio
    • 1
  • Fabio Accarpio
    • 1
  • Simone Sibio
    • 1
  • Daniele Biacchi
    • 1
  • Sergio Gazzanelli
    • 2
  • Anna M. Baccheschi
    • 1
  • Tommaso Cornali
    • 1
  • Marisa Di Seri
    • 3
  • Linda Cerbone
    • 3
  • Paolo Sammartino
    • 1
  1. 1.Department of Surgery “P. Valdoni”University of Rome “La Sapienza”RomeItaly
  2. 2.Department of Anaestesiology and Intensive CareUniversity of Rome “La Sapienza”RomeItaly
  3. 3.Department of Experimental MedicineUniversity of Rome “La Sapienza”RomeItaly

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