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

Peritoneal Carcinomatosis
Author: Paul H Sugarbaker
Publisher:
Total Pages: 288
Release: 1996-02-29
Genre:
ISBN: 9781461312468

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Peritoneal Carcinomatosis: Drugs and Diseases

Peritoneal Carcinomatosis: Drugs and Diseases
Author: Paul H. Sugarbaker
Publisher: Springer
Total Pages: 288
Release: 1996-02-29
Genre: Medical
ISBN: 9780792337263

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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

Peritoneal Carcinomatosis
Author: Paul H. Sugarbaker
Publisher: Kluwer Academic Publishers
Total Pages: 453
Release: 1995-10-01
Genre:
ISBN: 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.

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.

Exploring Drug Delivery to the Peritoneum

Exploring Drug Delivery to the Peritoneum
Author: Ranjita Shegokar
Publisher: Springer Nature
Total Pages: 244
Release: 2023-11-30
Genre: Science
ISBN: 3031316940

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The Peritoneal cavity (PC) is the key metastatic site for intra-abdominal malignancies (e.g., GI tract and rectal cancer). PC sites can be used to target several other diseases where lymphatic drug delivery is desired without dumping large amounts of the drug. Till recently, it was thought that treatment with curative intent was impossible but that was challenged by the introduction of cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC), and PIPAC (pressurized intraperitoneal aerosol chemotherapy). Recently, a growing number of preclinical and clinical studies advocate intraperitoneal (IP) chemotherapy as an alternative post-operative therapy for cancer. Although their effectiveness has been proven both experimentally and clinically, there is still little understanding of the role of drug delivery systems (DDS) in targeting drugs in the intraperitoneal (IP) cavity. There are two main challenges one posed by IP cavity where the residence time of a small molecular weight drug (20 kDa) is not sufficiently long to maintain therapeutic effect. This leads to frequent or continuous dosing. Another challenge is device-related or catheter-related problems, such as catheter obstruction, increased risk of infection, and bowel complications. Overall literature shows that the IP site is satisfactorily explored by clinicians but in terms of drug delivery not that much. One can see a clear-cut gap of expertise exchange between the two fields and guidelines from regulatory lawmakers on new medications./ppbr/ppIn summary, challenges like delivery to IP cavity, tumor or organ-specific targeting, efficient tissue penetration, optimal cellular uptake and intracellular residence of a drug, biocompatibility, toxicity, etc can be easily solved by smartly designing functional drug delivery systems (both nano and micro). Nanotechnologies have always fascinated humans for several decades and are now widely explored in the biomedical field. Diverse types of nanoparticles are being explored around the world, some examples include biodegradable nanoparticles, green nanoparticles, polymeric nanoparticles, lipid nanoparticles, metal nanoparticles, graphene, carbon nanotubes, and several others. Now a day's nanoparticles are gaining interest for drug targeting of chemotherapeutic drugs, immunotherapy, and gene delivery. Whereas microparticles can be explored for delayed drug delivery to the peritoneal cavity due to relatively slow removal from IP fluid. Hydrogels or other adhesive drug delivery may help to enhance peritoneal adhesions; thereby maintaining the balance between benefit and risk. Overall, drug delivery systems are key in IP targeting. That means drug delivery specialist and clinician needs to be connected to get the best out of this route of drug administration./ppbr/ppThe present book is a link between pharmaceutical scientists (drug formulators), clinicians, toxicologists, and regulatory experts. This book also provides a new perspective to researchers to divert or guide their research in an optimal way. Exploring Drug Delivery to the Peritoneum serves as a platform for upcoming technologies especially in the medical devices sector to face up and show potential in delivering drugs. It is a chance for commercial partners like insurance companies and the pharma industry to explore this direction./pp/pp

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.

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.

Utility of Bromelain and N-Acetylcysteine in Treatment of Peritoneal Dissemination of Gastrointestinal Mucin-Producing Malignancies

Utility of Bromelain and N-Acetylcysteine in Treatment of Peritoneal Dissemination of Gastrointestinal Mucin-Producing Malignancies
Author: Afshin Amini
Publisher: Springer
Total Pages: 246
Release: 2016-03-05
Genre: Medical
ISBN: 331928570X

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This volume will describe both growth-inhibitory and mucin-depleting effects of bromelain and N-acetylcysteine, on their own or in combination, in cancer. It will coherently review the pathophysiological aspects of the mucin glycoproteins in malignancies and provide an updated account of the status of bromelain and N-acetylcysteine in cancer therapy. The volume will develop the idea of using these two drugs as a combination formulation for mucin-depleting effects.