Prophylaxis of peritoneal carcinomatosis in experimental investigations

Abstract

Direct intraperitoneal chemotherapy with cisplatin or mitomycin prevents peritoneal carcinomatosis in experimental investigations.

Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for advanced gastric cancer

“…23 Peritoneal carcinomatosis from gastric cancer is likely to be multifactorial in etiology. There are a number of investigators who suggest that gastric cancers penetrating the serosa slough neoplastic cells into the peritoneal cavity, 1,9,11 and that it is these cells that are a nidus for future carcinomatosis. In 1959, Fisher et al 24 suggested that patients with gastrointestinal malignancies harbor high numbers of tumor cells within the portal blood.…”

“…12 Intraoperative spread of tumor cells stemming from disruption of lymphatic channels is also thought to contribute to seeding of the peritoneum and the subsequent development of carcinomatosis. 11 It is doubtful whether this can be routinely prevented during the extensive dissection requisite in the resection of gastric carcinoma. Further, irrigation with saline solution has been shown to be ineffective in removing any neoplastic cells that may have contaminated the peritoneal cavity during the course of cytoreductive surgery (CS).…”

“…14 Intraperitoneal instillation of chemotherapy has been shown to prevent the development of peritoneal carcinomatosis after implantation of neoplastic cells in an animal model. 11 When it is instilled directly into the peritoneal cavity, peak tissue concentrations of agent are much higher than those attained through the intravenous route. 13 The addition of hyperthermia to a chemotherapeutic agent acts synergistically with selected agents (such as mitomycin C) to increase the cell kill by a given dose of drug.…”

“…1,9,11 It has been shown that the area of serosal tumor invasion is positively correlated with the detection rate of intraperitoneal free cancer cells. 12 Intraoperative spread of tumor cells stemming from disruption of lymphatic channels is also thought to contribute to seeding of the peritoneum and the subsequent development of carcinomatosis.…”

A Novel Approach for the Increased Delivery of Pharmaceutical Agents to Peritoneum and Associated Lymph Nodes

“…Because 50% of patients with malignant gastrointestinal or gynecological diseases experience peritoneal carcinomatosis shortly after local curative resection, there is a great interest in delivering intraperitoneal chemotherapy during the perioperative period. In a recent study, Hribaschek et al (2001) found that the intraperitoneal administration of the chemotherapeutic agents cisplatin and mitomycin prevented perioperative peritoneal carcinomatosis in a rat model. The rats receiving cisplatin did, however, experience severe, local toxicity with bleeding into the peritoneum and toxic necrotic reactions of the colon.…”