Intraperitoneal chemotherapy for treatment and prevention of peritoneal carcinomatosis and sarcomatosis

Abstract

The treatment of peritoneal carcinomatosis and sarcomatosis has been associated with long-term disease-free survival. Recently, new intraperitoneal chemotherapy regimens used in patients with small volume peritoneal implants have shown benefits. After removal of all but minimal residual disease, the abdominal cavity is flooded with a large volume of fluid containing full systemic doses of chemotherapy. Adenocarcinoma patients receive mitomycin C and 5-fluorouracil; sarcoma patients receive cisplatin and doxirubicin. Long-term disease-free survival is seen in patients with low-grade malignancy, no lymph node or liver metastases, and a complete cytoreduction. If patients can be treated early when the volume of peritoneal surface cancer is low or if the patient can be made disease free by surgery, then intraperitoneal chemotherapy may be expected to achieve long-term disease-free survival in a majority of selected patients.