Yan T D, Esquivel J, Carmignani P, Sugarbaker P H
Washington Hospital Center, Washington, DC, USA.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):109-17.
Peritoneal surface malignancy can arise from pseudomyxoma peritonei, gastrointestinal carcinoma, abdomino-pelvic sarcoma and peritoneal mesothelioma. In the past, only palliative treatments were offered and the results were poor. We have proposed a new concept in managing patients with peritoneal surface malignancy. It involves an aggressive combined treatment modality of cytoreduction and perioperative intraperitoneal chemotherapy. The results are promising for patients with pseudomyxoma peritonei, peritoneal mesothelioma and well-selected patients with invasive peritoneal surface malignancies. The success in such comprehensive treatment depends on tumor biology, patient's co-morbidities, the completeness of cytoreduction, the efficacy of intraperitoneal chemotherapy administration and the surgeon's experience. The importance of patient selection is emphasized. The rationales and the outline of the current management strategies are described. Large phase II studies have demonstrated the marked survival advantage in this aggressive approach to peritoneal surface malignancy.
腹膜表面恶性肿瘤可起源于腹膜假黏液瘤、胃肠道癌、腹盆腔肉瘤和腹膜间皮瘤。过去，仅提供姑息性治疗，结果不佳。我们提出了一种治疗腹膜表面恶性肿瘤患者的新概念。它涉及减瘤手术和围手术期腹腔内化疗的积极联合治疗模式。对于腹膜假黏液瘤、腹膜间皮瘤以及经过精心挑选的侵袭性腹膜表面恶性肿瘤患者，结果很有前景。这种综合治疗的成功取决于肿瘤生物学特性、患者的合并症、减瘤的彻底性、腹腔内化疗给药的疗效以及外科医生的经验。强调了患者选择的重要性。描述了当前管理策略的基本原理和概要。大型II期研究已证明这种积极治疗腹膜表面恶性肿瘤的方法具有显著的生存优势。
