[Treatment of peritoneal carcinomatosis of gastro-intestinal origin--a retrospective study of 203 cases]

Rev Med Chir Soc Med Nat Iasi. 2012 Jan-Mar;116(1):150-6.
[Article in Romanian]

Abstract

Peritoneal carcinomatosis of gastrointestinal origin (PC-GI) is an advanced digestive tumor and is found in 10-30% of patients (P) with primary surgery for cancer (C) and up to 50% of C recurrences.

Aim: To evaluate the main characteristics, ethio-pathogenesis, prognosis and imaging to track of P with PC-GI admitted to the Third Surgical Clinic, "St. Spiridon" Hospital, Iaşi.

Material and methods: A retrospective study was carried out on series of 203 patients admitted in the period June 2006 - March 2011. The patients were aged between 27-80 years (average 62), with a women/men ratio of 95/108. The duration of hospitalization was between 1 and 61 days, with an average of 13.5 days for emergency cases and 15 days for elective cases. The data from observation files, the operating protocols, pathology reports and follow-up files were collected and analyzed.

Results: 136 patients were hospitalized with synchronous PC (the most common gastric N = 60) and 67 with metachronous PC (the most common colon N = 29). Imaging investigations consisted of ultrasound and computer tomography that showed a sensibility and specificity of 80% and 73% respectively, mainly in regard to ascites but less in assessing the presence of peritoneal deposits. The most common complication was septic shock and mortality was 9.5% (17 patients). Average survival was 5.7 months.

Conclusion: PC-GI is a disease with a poor prognosis, posing difficulties in early diagnosis, establishing the surgical indication and protocol. Consistent advances in systemic and locoregional chemotherapy, surgical techniques, intraoperative radiotherapy, as well as immunotherapy are expected to improve prognosis.

Publication types

  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Carcinoma / diagnosis
  • Carcinoma / drug therapy
  • Carcinoma / mortality
  • Carcinoma / surgery*
  • Chemotherapy, Adjuvant / methods
  • Female
  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / drug therapy
  • Gastrointestinal Neoplasms / mortality
  • Gastrointestinal Neoplasms / surgery*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Seeding
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / drug therapy
  • Neoplasms, Multiple Primary / mortality
  • Neoplasms, Multiple Primary / surgery*
  • Neoplasms, Second Primary / diagnosis
  • Neoplasms, Second Primary / drug therapy
  • Neoplasms, Second Primary / mortality
  • Neoplasms, Second Primary / surgery*
  • Peritoneal Neoplasms / diagnosis
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / surgery*
  • Prognosis
  • Retrospective Studies
  • Romania / epidemiology
  • Survival Rate
  • Treatment Outcome

Substances

  • Antineoplastic Agents