Peritoneal Carcinomatosis: Principles of ManagementPaul H. Sugarbaker 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. |
Contents
A review | 13 |
Pharmacokinetics of the peritonealplasma barrier after | 41 |
Peritonealplasma barrier | 53 |
Patterns of spread of recurrent intraabdominal sarcoma 65 | 64 |
Observations concerning cancer spread within | 79 |
In vitro pharmalogic rationale for intraperitoneal regional | 101 |
Immunotherapy for peritoneal ovarian carcinoma metastasis | 115 |
Role of omentumassociated lymphoid tissue in | 147 |
Progressive release of the left colon for a tensionfree | 255 |
Radiology of peritoneal carcinomatosis 263 | 262 |
Methodologic considerations in treatment using | 289 |
Safety constiderations in the use of intraoperative | 311 |
Treatment of peritoneal carcinomatosis from colon | 317 |
Effects of postoperative intraperitoneal chemotherapy | 326 |
Current status of staging laparotomy in colorectal | 337 |
Clinical research methodologies in diagnosis and staging | 358 |
Krukenberg syndrome as a natural manifestation of tumor | 162 |
Techniques | 193 |
Diffuse and gross peritoneal carcinomatosis treated | 210 |
Complications of heated intraperitioneal chemotherapy | 221 |
Peritonectomy procedures 235 | 234 |
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Common terms and phrases
abdominopelvic activity adenocarcinoma adhesions antigen appendix autologous ball-tip blood cancer cells cancer patients Cancer Res catheter cisplatin Clin Oncol clinical colon colorectal cancer concentration cuff cytoreductive cytoreductive surgery cytotoxicity debulking disease dissection dissemination distribution drug emboli entrapment epithelial fibrin Figure gastric cancer gastrointestinal cancer greater omentum growth Gynecol hemidiaphragm hyperthermic perfusion Immunol immunotherapy implants interleukin-2 intraabdominal intraoperative intraperitoneal chemotherapy intravenous IPHP Krukenberg Krukenberg tumor laparotomy liver lymph nodes lymphatic lymphocytes mAbs melanoma mesenteric mesothelium metastases mitomycin monoclonal antibody OALT ovarian cancer ovarian carcinoma ovarian metastases ovarian tumors ovary patients with ovarian patients with peritoneal perfusion peritoneal carcinomatosis peritoneal cavity peritoneal dialysis peritoneal fluid peritoneal surfaces peritonectomy peritoneum pharmacokinetic plasma preoperative primary cancer primary tumor procedure pseudomyxoma peritonei recurrence regions resection response result sarcoma small bowel studies Sugarbaker PH surgical survival systemic T-cell lines Tenckhoff catheter therapy tissue toxicity treatment tumor cells tumor nodules vitro volume µg/ml