Acute malignant obstruction in patients with peritoneal carcinomatosis: The role of palliative surgery

Publication date: Available online 21 December 2018Source: European Journal of Surgical OncologyAuthor(s): Nadine L. de Boer, Jan A.W. Hagemans, Bob T.A. Schultze, Alexandra R.M. Brandt-Kerkhof, Eva V.E. Madsen, Cornelis Verhoef, Jacobus W.A. BurgerAbstractIntroductionPatients with peritoneal carcinomatosis who do not have curative treatment options often develop acute obstructive symptoms and when conservative management fails, surgical treatment is the remaining option. However, palliative surgery is associated with high morbidity and mortality and the chance of success is unclear. The aim of this study was to evaluate outcomes of palliative surgery and to provide guidance for surgeons, medical oncologists and patients in their decision-making.MethodsAll consecutive patients who underwent palliative surgery for acute obstruction caused by peritoneal carcinomatosis between January 2005 and October 2017 where identified.ResultsIn total 148 patients underwent surgery. Primary malignancy was colorectal cancer (28.4%), neuroendocrine tumor (20.3%), ovarian cancer (14.2%) or ‘other’ (37.2%). Median length of postoperative hospital stay was 16 days (IQR 9–24). More than half (58.1%) of the patients developed postoperative complications, 29.1% developed ≥2 complications. In-hospital mortality was 8.8%. Readmission (56.1%) and re-obstruction (35.0%) were common. Median overall survival was 119 days (IQR 48–420). Patients with a neuroendocrine tumor had a s...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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Conditions:   Peritoneal Carcinomatosis;   Ovarian Cancer;   Colon Cancer Intervention:   Procedure: Cytoreductive surgery Sponsor:   University of Pisa Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Sharing a poster presentation done in Medcon2019 by Harika B 1styear PG& DR.ANV Prasad, Associate Professor NRI Institute of Medical Sciences CT Findings: Severe ascites seen. Multiple small enhancing nodules seen in the parietal peritoneum, visceral peritoneum and omentum with predominant pelvic distribution.Heterogeneously enhancing lesion of 3x2.1x1.8cm seen in RIF. Appendix is not seen separately from the lesion. Final Impression of Peritoneal carcinomatosis (pseudomyxoma peritoni) - likely due to mucinous adeno Ca. appendix.Peritoneal carcinomatosis(PC)  is the term given to malignant tumour seeding of ...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs
Background: Peritoneal carcinomatosis is a common metastatic pattern in ovarian, gastric, colorectal and appendiceal cancer; systemic chemotherapy is the current standard of care for peritoneal metastatic disease; however, in a subset of patients its beneficial effect remains questionable. More effective perioperative chemotherapy is needed. Materials and Methods: PIPAC is a new treatment that applies chemotherapeutic drugs into the peritoneal cavity as an aerosol under pressure. It's a safe and feasible approach that improves local bioavailability of chemotherapeutic drugs as compared with conventional intraperitoneal ch...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Abstract The results of PRODIGE 7 study demonstrate that the use of HIPEC is not beneficial for patients in the treatment of colorectal carcinomatosis. Nevertheless, a recent study published in NewEnglandJournalofMedicine showed that hyperthermic intraperitoneal chemotherapy (HIPEC) increased overall survival for patients with ovarian peritoneal carcinomatosis. Although, the emergence of targeted therapies (anti-angiogenic agents, PARP-inhibitors, anti-PDL1) results in new standards of treatment in first line or recurrence disease. In this general context, what is the potential interest of HIPEC for the treatment ...
Source: Bulletin du Cancer - Category: Cancer & Oncology Authors: Tags: Bull Cancer Source Type: research
Conclusions: Compared with whole body PET/CT, additional regional PET/MR with high soft-tissue resolution helps to find more metastasis lesions, detect primary tumors with enhanced confidence or even amend the diagnosis. Compared with whole body PET/MR, additional regional PET/MR assisting to whole body PET/CT protocol reduces time and should be an alternative for advanced stage patients with severe condition. However, in this protocol the additional PET/MR has limited field to evaluate the diffuse metastasis and the scan region was highly dependent on previous whole body PET/CT and the experience of doctor
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Outcomes/Infectious Disease/Pulmonary Posters Source Type: research
Conclusions: This meta-analysis demonstrated that CD44 overexpression might be an unfavorable prognostic factor for CRC patients and could be used to predict poor differentiation, lymph node metastasis and distant metastasis. Introduction Although therapies for colorectal cancer (CRC) has improved in recent years, colorectal cancer is still the third most common cause of cancer related death worldwide (1). Metastasis are observed in 25% of patients at initial diagnosis and approximately 50% of patients will develop metastasis (2). Presently, the outcome prediction and the therapy schedule determination of CRC patie...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
This study protocol was approved by the Institutional Review Board of the hospital. Data Collection Demographic and clinical data were retrieved from medical records in the hospital’s centralized database. These data included the age at diagnosis, International Federation of Obstetrics and Gynecologic (FIGO) stage, tumor histology and grade, type of surgery, and types and cycles of chemotherapy. Disease staging was based on the 2014 FIGO staging system. Optimal debulking surgery was defined as residual tumors with maximal diameters less than 1 cm; the others were defined as suboptimal debulking surgery. Disease rec...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
AbstractTo explore the relationship of peritoneal, and rectal involvement with lymph nodal metastases to identify clinical parameters to guide systematic nodal dissection in advanced ovarian cancer (stage 3c). It is a retrospective study of stage III C epithelial ovarian cancers undergoing cytoreductive surgery with systematic nodal dissection, from January 2011 to December 2016. LS3 score is a cumulative score given for the presence of size 3 lesion (peritoneal disease measuring more than 5 cm) in regions 5, 6, and 7. The depth of rectal involvement was assigned progressive numerical values from 1 (for serosa) to maximum ...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsOur study shows that good results may be achieved in terms of symptom palliation and improvement of quality of life in very advanced cancer patients with MA from PC. The treatment was generally well tolerated considering the limited treatment options available for these patients.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
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