Yang Liu1,2, Haruaki Ishibashi3,4, Kazuyoshi Takeshita3,4, Akiyoshi Mizumoto5, Masamitsu Hirano5, Shouzou Sako3, Shigeru Takegawa3, Nobuyuki Takao5, Masumi Ichinose5, Yutaka Yonemura6,7,8,9. 1. NPO to Support Peritoneal Surface Malignancy Treatment, Kyoto, Osaka, Japan. lymikeleo@hotmail.com. 2. Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan. lymikeleo@hotmail.com. 3. NPO to Support Peritoneal Surface Malignancy Treatment, Kyoto, Osaka, Japan. 4. Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan. 5. Department of Surgery, Kusatsu General Hospital, Kusatsu, Shiga, Japan. 6. NPO to Support Peritoneal Surface Malignancy Treatment, Kyoto, Osaka, Japan. y.yonemura@coda.ocn.ne.jp. 7. Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan. y.yonemura@coda.ocn.ne.jp. 8. Department of Surgery, Kusatsu General Hospital, Kusatsu, Shiga, Japan. y.yonemura@coda.ocn.ne.jp. 9. , Kyoto, Japan. y.yonemura@coda.ocn.ne.jp.
Abstract
BACKGROUND: Peritoneal dissemination is a frequent pattern of recurrence and metastasis of small bowel malignancy (SBM). However, the survival of patients with peritoneal dissemination from SBM is not clear, and there is no consensus on the treatment for it. PATIENTS AND METHODS: A total of 31 selected patients with peritoneal dissemination from SBM were treated by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) between January 2006 and January 2014. The major focus of this study was overall survival, as well as morbidity and mortality. RESULTS: Twenty-five patients had small bowel adenocarcinoma (SBA), and six patients had non-adenocarcinoma SBM. HIPEC was performed on 21 patients, and 21 patients received complete cytoreduction. There was no treatment-related mortality, and eight (25.8 %) patients had grade 3-4 complications. Until the latest follow-up, the median survival of 31 patients after CRS and HIPEC was 36 months (range 5-95 months), and the median survival after diagnosis was 51 months (range 18-101 months). For 25 patients with peritoneal carcinomatosis from SBA, the median survival after CRS and HIPEC was 36 months (range 6-95 months), and the median survival after diagnosis was 50 months (range 18-101 months). Multivariate analysis revealed that peritoneal cancer index <15 (p = 0.009) and HIPEC (p < 0.001) were independent predictors of better survival in patients with peritoneal dissemination from SBM treated by CRS and HIPEC. CONCLUSIONS: Until more data become available, a reasonable strategy for the treatment of SBM is CRS and HIPEC. It can be applied with acceptable safety in selected patients with peritoneal dissemination from SBM.
BACKGROUND: Peritoneal dissemination is a frequent pattern of recurrence and metastasis of small bowel malignancy (SBM). However, the survival of patients with peritoneal dissemination from SBM is not clear, and there is no consensus on the treatment for it. PATIENTS AND METHODS: A total of 31 selected patients with peritoneal dissemination from SBM were treated by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) between January 2006 and January 2014. The major focus of this study was overall survival, as well as morbidity and mortality. RESULTS: Twenty-five patients had small bowel adenocarcinoma (SBA), and six patients had non-adenocarcinoma SBM. HIPEC was performed on 21 patients, and 21 patients received complete cytoreduction. There was no treatment-related mortality, and eight (25.8 %) patients had grade 3-4 complications. Until the latest follow-up, the median survival of 31 patients after CRS and HIPEC was 36 months (range 5-95 months), and the median survival after diagnosis was 51 months (range 18-101 months). For 25 patients with peritoneal carcinomatosis from SBA, the median survival after CRS and HIPEC was 36 months (range 6-95 months), and the median survival after diagnosis was 50 months (range 18-101 months). Multivariate analysis revealed that peritoneal cancer index <15 (p = 0.009) and HIPEC (p < 0.001) were independent predictors of better survival in patients with peritoneal dissemination from SBM treated by CRS and HIPEC. CONCLUSIONS: Until more data become available, a reasonable strategy for the treatment of SBM is CRS and HIPEC. It can be applied with acceptable safety in selected patients with peritoneal dissemination from SBM.
Authors: Natasha Leigh; Daniel Solomon; Eric Pletcher; Daniel M Labow; Deepa R Magge; Umut Sarpel; Benjamin J Golas Journal: World J Surg Oncol Date: 2020-07-23 Impact factor: 2.754
Authors: Yang Liu; Yutaka Yonemura; Edward A Levine; Olivier Glehen; Diane Goere; Dominique Elias; David L Morris; Paul H Sugarbaker; Jean J Tuech; Peter Cashin; John D Spiliotis; Ignace de Hingh; Wim Ceelen; Joel M Baumgartner; Pompiliu Piso; Kanji Katayama; Marcello Deraco; Shigeki Kusamura; Marc Pocard; François Quenet; Sachio Fushita Journal: Ann Surg Oncol Date: 2018-02-26 Impact factor: 5.344