Peritoneal Carcinomatosis: Principles of Management

Peritoneal Carcinomatosis: Principles of Management
Author: Paul H. Sugarbaker
Publisher: Springer Science & Business Media
Total Pages: 434
Release: 2012-12-06
Genre: Medical
ISBN: 1461312477

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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

Peritoneal Carcinomatosis: A Multidisciplinary Approach
Author: wim ceelen
Publisher: Springer Science & Business Media
Total Pages: 548
Release: 2007-03-06
Genre: Medical
ISBN: 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

Peritoneal Carcinomatosis: Drugs and Diseases
Author: Paul H. Sugarbaker
Publisher: Springer Science & Business Media
Total Pages: 288
Release: 2012-12-06
Genre: Medical
ISBN: 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.

Peritoneal Carcinomatosis from Ovarian Cancer

Peritoneal Carcinomatosis from Ovarian Cancer
Author: Konstantinos N. Chatzigeorgiou
Publisher: Nova Science Publishers
Total Pages: 234
Release: 2005
Genre: Metastasis
ISBN:

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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.

Treatment of Peritoneal Surface Malignancies

Treatment of Peritoneal Surface Malignancies
Author: Angelo Di Giorgio
Publisher: Springer
Total Pages: 398
Release: 2015-02-14
Genre: Medical
ISBN: 8847057116

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This monograph summarizes state of the art knowledge regarding peritoneal surface malignancies, with in-depth description of treatment options and the results achieved to date. It explores the most challenging problems on the basis of the authors’ very extensive clinical experience and examines the most relevant clinical trials. A comprehensive summary is provided of all phase 2 studies (the only available completed studies) and of ongoing and future phase 3 studies. Particular attention is paid to the results of integrated treatment comprising cytoreduction (peritonectomy) and hyperthermic intraperitoneal chemotherapy (HIPEC). Helpful background information is also included on the definition and clinical assessment of each clinical form. The book, drawing on data from the entire Italian experience as well as world literature, will be an outstanding benchmark for health professionals and researchers.

Peritoneal Surface Malignancies

Peritoneal Surface Malignancies
Author: Emel Canbay
Publisher: Springer
Total Pages: 127
Release: 2015-07-09
Genre: Medical
ISBN: 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.

Gastric Peritoneal Carcinomatosis

Gastric Peritoneal Carcinomatosis
Author: Fernando López Mozos
Publisher: Nova Science Publishers
Total Pages: 270
Release: 2021
Genre: Medical
ISBN: 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"--

Management of Peritoneal Metastases- Cytoreductive Surgery, HIPEC and Beyond

Management of Peritoneal Metastases- Cytoreductive Surgery, HIPEC and Beyond
Author: Aditi Bhatt
Publisher: Springer
Total Pages: 577
Release: 2018-04-02
Genre: Medical
ISBN: 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.

Perioperative Chemotherapy

Perioperative Chemotherapy
Author: U. Metzger
Publisher: Springer Science & Business Media
Total Pages: 170
Release: 2012-12-06
Genre: Medical
ISBN: 3642824323

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One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.

Pathology of Peritoneal Metastases

Pathology of Peritoneal Metastases
Author: Olivier Glehen
Publisher: Springer Nature
Total Pages: 281
Release: 2020-04-30
Genre: Medical
ISBN: 9811537739

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This book covers some well-known and some unexplored pathological aspects of management of peritoneal metastases and should be read by both surgeons and pathologists involved in the management of peritoneal surface malignancies. The evaluation of cytoreductive surgery specimens is explored for the prognostic information it can provide and recommendations for evaluation of such specimens are provided. The pathways and patterns of peritoneal dissemination and their clinical implications on the extent of surgery performed and other aspects of management are discussed for some common peritoneal tumours. The exploratory studies presented here provide a new perspective on the surgical resection of peritoneal metastases. Other important aspects of pathological evaluation like pathological response to chemotherapy, diagnosis and classification of rare peritoneal tumors have also been covered in different chapters. Keeping in sync with the progress in molecular oncology, the role of molecular oncology in the current and future management of peritoneal metastases is addressed for different tumors.