Pilati P, Rossi C R, Mocellin S, Foletto M, Scagnet B, Pasetto L, Lise M
Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e Chirurgiche, Padova, Italy.
Eur J Surg Oncol. 2001 Mar;27(2):125-34. doi: 10.1053/ejso.2000.1021.
Peritoneal carcinomatosis and sarcomatosis (PCS) are short-term fatal conditions amenable only to palliative treatment. They are generally considered as a systemic disease at clinical presentation, and are resistant to standard treatments. However, there may be in the natural history a phase of loco-regional tumour spread during which the tumour may still be curable. Surgical treatment alone, or in combination with systemic chemotherapy, has yielded poor results in terms of survival and quality of life. One approach is cytoreductive surgery (CS) combined with the intraperitoneal administration of antiblastic agents. This may diminish any residual tumour following macroscopic excision and may overcome the pharmacokinetic limits of systemic chemotherapy. A further improvement in this multimodal approach may be achieved by the use of hyperthermic intraperitoneal intraoperative chemotherapy (HIIC). Results so far have been encouraging. However, series reported in the literature are relatively small and heterogeneous, and clinical and technical factors which include the selection of patients, optimal drugs dosage and temperature, evaluation of outcome and costs are still under discussion.
腹膜癌病和肉瘤病（PCS）是短期致命性疾病，仅适合姑息治疗。在临床表现上，它们通常被视为一种全身性疾病，并且对标准治疗有抗性。然而，在其自然病程中可能存在一个局部区域肿瘤扩散阶段，在此阶段肿瘤可能仍可治愈。单独的手术治疗或与全身化疗联合使用，在生存和生活质量方面都产生了较差的结果。一种方法是细胞减灭术（CS）联合腹腔内给予抗增殖药物。这可能会减少宏观切除后残留的任何肿瘤，并可能克服全身化疗的药代动力学限制。通过使用术中腹腔内热化疗（HIIC），这种多模式方法可能会进一步改进。迄今为止的结果令人鼓舞。然而，文献中报道的系列相对较小且异质性较大，包括患者选择、最佳药物剂量和温度、结果评估以及成本等临床和技术因素仍在讨论中。
