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Peritoneal Carcinomatosis: Principles of Management

Author: Paul H. Sugarbaker

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 434

ISBN-13: 1461312477

Paul Sugarbaker and his colleagues have persevered in the study and treat ment of peritoneal carcinomatosis. The peritoneal cavity has many unique and incompletely appreciated properties. These properties, coupled with the biologic behavior of many cancers, results in the seeding and growth of these cancers on the peritoneum. Many of these cancers remain localized to the peritoneum only, never metastasizing to other sites. One possible reason for this may be the obstruction of the afferent lymphatics on the undersurface of the diaphragm. The mucopolysaccharides produced by many of these neoplasma are probably viscous enough to obstruct these lymphatics, leading to the syndrome of pseudomyxoma peritonei. Many of the neoplasms taking residence on the peritoneum have extremely long cell-cycle times and are resistant to radiotherapy and many chemotherapeutic agents. How ever, much can be done for these patients - resection of primary cancers, omentectomies to reduce ascites formation, management of recurrent ascites, management of intestinal obstruction, nutritional care, and, hopefully, intraperitoneal chemotherapy. We have reviewed many of these problems in the past [1-7]. Dr. Sugarbaker and his colleagues have organized the current state of knowledge and technology for continuing use. The book provides a basis for thoughtful, prospective research planning. John S. Spratt, M. D. , F. A. C. S. Professor of Surgery The James Graham Brown Cancer Center University of Louisville Louisville, Kentucky References 1. Long RTL, Spratt JS, Dowling E.

Peritoneal Carcinomatosis: A Multidisciplinary Approach

Author: wim ceelen

Publisher: Springer Science & Business Media

Published: 2007-03-06

Total Pages: 548

ISBN-13: 0387489932

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This is the first volume to provide a multidisciplinary approach to peritoneal carcinomatosis encompassing molecular mechanisms, histopathology, regional and systemic cytotoxic therapy, and surgical options. Illustrations aid the reader throughout in the many facets of this disease. The book will be of particular interest for medical, surgical and gynecological oncologists faced with the complexities of decision making in patients suffering from PC.

Peritoneal Carcinomatosis: Drugs and Diseases

Author: Paul H. Sugarbaker

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 288

ISBN-13: 1461312450

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Peritoneal carcinomatosis dominates the clinical picture of many patients with gastrointestinal, gynecological and urological cancers. For many of them its dev astating effects contribute directly to their death. Most clinicians consider peritoneal carcinomatosis an incurable metastatic disease and give palliative treatment, re stricted to limited surgery and systemic chemotherapy. Contrary to this view, Paul Sugarbaker and his collegues base their approach on the concept that peritoneal carcinomatosis represents regional tumor spread, similar in its impact on treatment and prognosis to that of lymph node metastases in other malignancies. This concept emphasises the value of regional tumor control, as a potentially curative measure. In this book the combination of aggressive cytoreduction and intraperitoneal chemotherapy to control peritoneal carcinomatosis is extensively explored. Basic to this approach is the observation that most cancer cells show only relative resistence against commonly available drugs, which can be overcome by a sufficient increase of drug concentrations in tumor tissue. After intraperitoneal delivery, drugs will reach high tissue concentrations in the superficial few cell layers, while plasma concentrations will remain below toxic levels. Patients with only limited residual tumor at the peritoneal surface after cytoreduction may therefore benefit from intraperitoneal chemotherapy.

Gastric Peritoneal Carcinomatosis

Author: Fernando López Mozos

Publisher: Nova Science Publishers

Published: 2021

Total Pages: 270

ISBN-13: 9781536196023

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"Gastric cancer is the fourth most common cancer in the world. Most gastric cancers are diagnosed in advanced stages, and the prognosis remains poor. The 5-year survival rate is 40-60% in eastern countries and around 25% in the west. Among advanced gastric cancer cases, peritoneal implantation is one of the most common forms of metastasis and around 14% of cases present peritoneal metastases at initial diagnosis, presenting a survival of 3-6 months. Until the early 1990s it was considered a terminal disease. But today these patients have some opportunities to be treated with curative intent or to prolong their life. Although the prognosis remains poor, there are some treatment options including cytoreductive surgery, neoadjuvant therapy, and some forms of intraperitoneal chemotherapy with or without hyperthermia. These are aggressive treatments, so we must be careful when selecting patients. Imaging and preoperative staging are also crucial in selecting patients for appropriate treatment. The surgical technique is described and a detailed demonstration video is available in the e-book version. New forms of treatment such as PIPAC and new scientific advances and future perspectives are discussed. This book is an update on this topic and attempts to provide an overview for all medical personnel involved in the treatment of these patients"--

Peritoneal Carcinomatosis from Ovarian Cancer

Author: Konstantinos N. Chatzigeorgiou

Publisher: Nova Science Publishers

Published: 2005

Total Pages: 234

ISBN-13:

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Ovarian cancer is the most common cause of death among all gynecological neoplasms. Ovarian epithelial cancer represents approximately 90% of all ovarian malignant tumours. The most usual pattern of spread and probably the earliest kind of metastasis of ovarian cancer is intraperitoneal spread, caused by apoptosis of viable cancer cells, even in cases where the ovarian surface has no visible rupture. Approximately 70% to 75% of all ovarian cancers are being diagnosed with peritoneal carcinomatosis and ascites in advanced stages III and IV. Peritoneal carcinomatosis from ovarian cancer may occur either concomitantly with the primary tumour or as a recurrence pattern of spread. Standard treatment consists of surgical debulking and postoperative systemic chemotherapy. Response rates to first-line chemotherapy with platinum/taxane combinations are high, about 70-80%, but the vast majority of patients will relapse. Peritoneal seeding is a major cause of surgical treatment failure among those patients, even after optimal debulking. However, progressing ovarian cancer tends to remain within the peritoneal cavity or, better-expressed, ovarian cancer is a cancer of the peritoneum. The administration of cytotoxic agents directly into the peritoneal cavity as treatment for malignancy was initially evaluated more than 40 years ago. Over the past two decades regional therapy of ovarian cancer has evolved from just an interesting pharmacokinetic concept into a viable management option for women with advanced disease. Several authors, and among them some of the world's leading experts on this field present the current knowledge and their experience on peritoneal carcinomatosis from ovarian cancer.

Selective Heat Sensitivity of Cancer Cells

Author: A. Rossi-Fanelli

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 334

ISBN-13: 3642810802

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Since the first observations of Busch in 1866, the possible use of heat as a therapeutic agent in the cure of cancer has been repeatedly subject to bursts of interest, almost invariably followed by periods of neglect and skepticism. In 1963-1964, this problem was again attacked by us both from the biochemical and from the clinical points of view. The first results of this joint effort were positive beyond expectation, and generated a new revial of studies aimed at the identification of the nature of the bio chemical lesion as well as at the optimization of technique and of the therapeutic schedules connected with clinical use. Although the number of mammalian tumors which have been proved to be heat-sensitive is now relatively large, and although in some cases a correlation has been demonstrated between tumorigenicity and heat-sensitivity of in vitro cultured cell lines, the question of a direct and constant relationship between neoplastic character and higher sensitivity to hyperthermic exposure is still open to continuing investigation and reappraisal. Several studies deal in fact with the determination of the conditions under which, in vitro and or in vivo, different tumors are efficiently damaged by elevated temperatures.

Peritoneal Tumors and Metastases

Author: Beate Rau

Publisher: Springer Nature

Published: 2021-05-13

Total Pages: 407

ISBN-13: 3030626407

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This book provides surgeons and oncologists with a well-founded and detailed overview of the available treatment options for peritoneal malignancy and differential selection of the appropriate forms of therapy. Systemic chemotherapy options are also considered, as are surgical cytoreduction (CRS) and all forms of intraperitoneal chemotherapy (IPC) especially hyperthermic IPC (HIPEC), and immunotherapy, including specific procedures such as PIPAC. Subsequent chapters address perioperative care, complications and recurrences, as well as psycho-oncological, palliative medical and nursing care. The process of parietal and visceral peritonectomy in the large and small intestine is additionally illustrated by three video clips accessible online. Covering a broad range of aspects, including peritoneal metastasis and intraperitoneal chemotherapy, the book offers a valuable tool for surgeons, oncologists and anesthesiologists alike.

Peritoneal Surface Malignancies

Author: Emel Canbay

Publisher: Springer

Published: 2015-07-09

Total Pages: 109

ISBN-13: 3319129376

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This book has been designed to provide the full description of the comprehensive management of peritoneal surface malignancies as a new emerging specialty. Combined treatment of cytoreductive surgery (CRS) and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) introduced by our leader Paul H. Sugarbaker are performed to treat peritoneal metastases by surgeons all around the world. Therefore this book is focused on detailed surgical anatomy of the peritoneum, preoperative clinical assessment of the peritoneal surface malignancy, patient preparation and operation room equipments, different surgical procedures for CRS and reconstruction, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy (EPIC) and molecular basis of peritoneal surface malignancies. The chapter on molecular mechanisms of the formation of peritoneal carcinomatosis provides insight into a rapidly expanding knowledge within this speciality. This book should be valuable for surgical oncologists who deal with multimodal treatment for peritoneal surface malignancies, as well as for the trained peritonectomy surgeons. For the senior surgeons, it will also introduce new techniques and approaches in this field such as dealing with the omental cakes and massive organ involvement that requires multi-organ resection.

Management of Peritoneal Metastases- Cytoreductive Surgery, HIPEC and Beyond

Author: Aditi Bhatt

Publisher: Springer

Published: 2018-04-02

Total Pages: 580

ISBN-13: 9811070539

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The widespread acceptance among the oncology community at large of cytoreductive surgery and HIPEC as a potentially curative treatment for peritoneal metastases has paved the way for innovative new therapies that could benefit a larger proportion of patients. Much has been and continues to be published on this subject. This book provides comprehensive reviews on the various aspects of managing peritoneal metastases. The authors highlight essential practical issues that surgical oncologists encounter in their day-to-day practice, and try to before provide evidence based answers to address them. All chapters were written and/or reviewed by leading experts in this field.

Peritoneal Carcinomatosis

Author: Paul H. Sugarbaker

Publisher: Kluwer Academic Publishers

Published: 1995-10-01

Total Pages: 453

ISBN-13: 9780792334897

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The dissemination of cancer on peritoneal surfaces has hitherto been regarded as a terminal condition. Only a few patients with ovarian cancer - a disease where there is extreme drug sensitivity - have been maintained in a disease-free state over the long term. The tumour biology questions are as follows: Is the dissemination of cancer on peritoneal surfaces to be regarded as finite spread of malignancy, or as evidence of systematic disease? Is peritoneal carcinomatosis in selected patients a limited process that can be treated for cure, using surgery and chemotherapy? Can treatments lead to a complete resolution of the cancerous process? Most oncologists would regard peritoneal carcinomatosis as a condition that can only be palliated. This book presents the principles that support aggressive management plans with disease eradication as an end point.New technologies have emerged, bringing about this conceptual change in thinking. Technologies have been developed for complete chemotherapeutic treatment of all peritoneal surfaces. Technologies have been developed for uncovering minute foci of disease in remote portions of the abdomen. Also, new surgical and electrosurgical techniques are important aspects of this revised management plan. Even the data management tools required to quantitate improvements in treatment have been developed, and are presented here.The book shows that peritoneal carcinomatosis can be treated and that complete eradication of malignancy can occur.