Title Page | Introduction | Principles of Intraperitoneal Chemotherapy | Current Indications for Cytoreductive Surgery and Intraperitoneal Chemotherapy
Heated Intraoperative Intraperitoneal Chemotherapy by the Coliseum Technique
Immediate Postoperative Abdominal Lavage in Preparation for Early Postoperative Intraperitoneal 5-Fluorouracil
Early Postoperative Intraperitoneal Chemotherapy for Adenocarcinoma | Induction Intraperitoneal Chemotherapy for Debilitating Ascites
Cytoreductive Surgery for Peritoneal Surface Malignancy - Peritonectomy Procedures | Results of Treatment of Peritoneal Surface Malignancy
Conclusions | References




IX. CONCLUSIONS


Changes in the use of chemotherapy in patients with peritoneal carcinomatosis and sarcomatosis have been presented along wit h early favorable results of treatment. A change in the ROUTE of drug administration has occurred. Chemotherapy is given intraperitoneally, or by combined intraperitoneal and intravenous routes. Also, a change in TIMING has occurred so that chemotherapy delivery begins in the operating room and may continue for the first five postoperative days. In selecting patients with high-grade cancer for treatment, the Peritoneal Cancer Index is of crucial importance. Only patients who have a complete cytoreduction are likely to respond with long-term survival and the Peritoneal Cancer Index provides a reliable way to select these patients. The treatment of large volume4ow-grade tumors following complete cytoreduction has shown beneficial results especially in the pseudomyxoma peritonei syndrome. Aggressive treatment of a large volume of high grade intraabdominal cancer is unlikely to produce long-term benefits, and is often the cause of excessive morbidity and mortality.



Title Page | Introduction | Principles of Intraperitoneal Chemotherapy | Current Indications for Cytoreductive Surgery and Intraperitoneal Chemotherapy
Heated Intraoperative Intraperitoneal Chemotherapy by the Coliseum Technique
Immediate Postoperative Abdominal Lavage in Preparation for Early Postoperative Intraperitoneal 5-Fluorouracil
Early Postoperative Intraperitoneal Chemotherapy for Adenocarcinoma | Induction Intraperitoneal Chemotherapy for Debilitating Ascites
Cytoreductive Surgery for Peritoneal Surface Malignancy - Peritonectomy Procedures | Results of Treatment of Peritoneal Surface Malignancy
Conclusions | References