Skip to main content

Advertisement

SpringerLink
Log in

Staged laparoscopic adjuvant intraperitoneal chemohyperthermia after complete resection for locally advanced colorectal or gastric cancer: a preliminary experience

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Cytoreductive surgery followed by intraperitoneal chemohyperthermia (IPCH) is a promising treatment for patients with peritoneal carcinomatosis, a disease with dismal prognosis.

Methods

We describe our preliminary experience with staged adjuvant laparoscopic IPCH after complete resection in patients with locally or regionally advanced colorectal or gastric cancer.

Results

Twenty-one patients underwent resection for colorectal (N = 16) or gastric cancer (N = 5) followed by staged laparoscopic IPCH. No conversion to laparotomy was required. No major operative incident occurred. Mean duration of hospital stay was 12 days (range 9–23 days). No mortality occurred in the 30-day postoperative period. Four patients developed major complications (19%). One patient (5%) was reoperated. Mean follow-up period was 15.5 months (range 9–29 months). Three patients died, including two of cancer-related causes. No patient developed peritoneal carcinomatosis during the follow-up period.

Conclusion

Staged laparoscopic adjuvant IPCH after open or laparoscopic resection in selected patients with colorectal or gastric cancer is feasible and reasonably safe. However, additional data are required to determine the effect on long-term survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Dawson LE, Russell AH, Tong D et al (1983) Adenocarcinoma of the sigmoid colon: sites of initial dissemination and clinical patterns of recurrence following surgery alone. J Surg Oncol 22:95–99

    Article  PubMed  CAS  Google Scholar 

  2. Chu DZ, Lang NP, Thompson C et al (1989) Peritoneal carcinomatosis in nongynecologic malignancy: a prospective study of prognostic factors. Cancer 63:364–367

    Article  PubMed  CAS  Google Scholar 

  3. Sadeghi B, Arvieux C, Glehen O et al (2000) Peritoneal carcinomatosis from non-gynecologic malignancies. Results of the EVOCAPE1 multicentric prospective study. Cancer 88:358–863

    Article  PubMed  CAS  Google Scholar 

  4. Chu DZ, Lang NP, Thompson C, Osteen PK, Westbrook KC (1989) Peritoneal carcinomatosis in nongynecologic malignancy. A prospective study of prognostic factors. Cancer 63:364–367

    Article  PubMed  CAS  Google Scholar 

  5. Glehen O, Osinsky D, Beaujard AC, Gilly FN (2003) Natural history of peritoneal carcinomatosis from nongynecologic malignancies. Surg Oncol Clin North Am 12:729–739

    Article  Google Scholar 

  6. Knorr C, Reingruber B, Meyer T et al (2004) Peritoneal carcinomatosis of colorectal cancer: incidence, prognosis, and treatment modalities. Int J Colorectal Dis 19:181–187

    Article  PubMed  CAS  Google Scholar 

  7. Yan TD, Black D, Savady R, Sugarbaker PH (2006) Systematic review on the efficacy of cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal carcinoma. J Surg Oncol 24:4011–4019

    Google Scholar 

  8. Glehen O, Gilly FN, Sugarbaker PH (2003) New perspectives in the management of colorectal cancer: what about peritoneal carcinomatosis? Scand J Surg 92:178–179

    PubMed  CAS  Google Scholar 

  9. Xu DZ, Zhan YQ, Sun XW, Cao SM, Geng QR (2004) Meta-analysis of intraperitoneal chemotherapy for gastric cancer. World J Gastroenterol 10:2727–2730

    PubMed  Google Scholar 

  10. Sugarbaker PH, Chang D (1999) Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy. Ann Surg Oncol 6:727–731

    Article  PubMed  CAS  Google Scholar 

  11. Glehen O, Schreiber V, Cotte E et al (2004) Cytoreductive surgery and intraperitoneal chemohyperthermia for peritoneal carcinomatosis arising from gastric cancer. Arch Surg 139:20–26

    Article  PubMed  CAS  Google Scholar 

  12. Glehen O, Kwiatkowski F, Sugarbaker PH et al (2004) Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol 22:3284–3292

    Google Scholar 

  13. Feldman AL, Libutti SK, Pingpank JF et al (2003) Analysis of factors associated with outcome in patients with malignant peritoneal mesothelioma undergoing surgical debulking and intraperitoneal chemotherapy. J Clin Oncol 21:4560–4567

    Article  PubMed  CAS  Google Scholar 

  14. Fujimoto S, Shrestha RD, Kokubun M et al (1988) Intraperitoneal hyperthermic perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding. Ann Surg 208:36–41

    Article  PubMed  CAS  Google Scholar 

  15. Stephens AD, Alderman R, Chang D et al (1999) Morbidity and mortality analysis of 200 treatments with cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy using the coliseum technique. Ann Surg Oncol 6:790–796

    Article  PubMed  CAS  Google Scholar 

  16. Hamazoe R, Maeta M, Kaibara N (1994) Intraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer. Final results of a randomized controlled study. Cancer 73:2048–2052

    Article  PubMed  CAS  Google Scholar 

  17. Zoetmuller FA (1996) Cancer cell seeding during abdominal surgery: experimental studies. In: Sugarbaker PH (ed) Peritoneal carcinomatosis: principles of management. Kluwer Academic, Boston, pp 155–162

  18. Scheithauer W, Kornek GV, Marczell A et al (1998) Combined intravenous and intraperitoneal chemotherapy with fluorouracil + leucovorin vs fluorouracil + levamisole for adjuvant therapy of resected colon carcinoma. Br J Cancer 77:1349–1354

    PubMed  CAS  Google Scholar 

  19. Wang XG, Fu J, Zheng H, Li GX, Luo RC (2006) Effects of pirarubicin chemotherapy combined with hyperthermia on gastric cancer in vitro. Nan Fang Yi Ke Da Xue Xue Bao 26:1487–1490

    PubMed  CAS  Google Scholar 

  20. Glehen O, Cotte E, Lifante JC et al (2006) Peritoneal carcinomatosis in digestive cancers: cytoreductive surgery combined with intraperitoneal chemohyperthermia. The experience in Centre Hospitalier et Universitaire Lyon Sud (CHLS). Acta Chir Belg 106:285–290

    PubMed  CAS  Google Scholar 

  21. Glehen O, Mohamed F, Gilly FN (2004) Peritoneal carcinomatosis from digestive tract cancer: new management by cytoreductive surgery and intraperitoneal chemohyperthermia. Lancet Oncol 5:219–228

    Article  PubMed  Google Scholar 

  22. Mussa A, Sandrucci S, Zanon C (2001) Intraoperative chemohyperthermia for advanced gastric cancer: a new procedure with closed abdomen and previously constructed anastomosis. Tumori 87:S18–S20

    PubMed  CAS  Google Scholar 

  23. Roukos DH (2000) Current status and future perspectives in gastric cancer management. Cancer Treat Rev 26:243–245

    Article  PubMed  CAS  Google Scholar 

  24. Verwaal VJ, van Ruth S, de Bree E et al (2003) Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol 21:3737–3743

    Article  PubMed  Google Scholar 

  25. Fingerhut A, Ata T, Chouillard E, Alexakis N, Veyrie N (2007) Laparoscopic approach to colonic cancer: critical appraisal of the literature. Dig Dis 25:33–43

    Article  PubMed  Google Scholar 

  26. Chouillard E, Fingerhut A (2005) Intraperitoneal chemohyperthermia for digestive tract cancer with peritoneal carcinomatosis. The American College of Surgery, The Lebanon Chapter, September 5th 2005, Beirut. Oral presentation

  27. Chouillard E, Fauconnier A, Ville Y. Long term survival is possible after cytoreductive surgery coupled with chemohyperthermia in patients with stage III ovarian cancer. 16th annual congress of the European Society of Gynecological Endoscopy (ESGE), September 5–8, Portoroz, Slovenia. Oral presentation

  28. Glehen O, Cotte E, Schreiber V, Sayag-Beaujard AC, Vignal J, Gilly FN (2004) Intraperitoneal chemohyperthermia and attempted cytoreductive surgery in patients with peritoneal carcinomatosis of colorectal origin. Br J Surg 91:747–754

    Article  PubMed  CAS  Google Scholar 

  29. Glehen O, Kwiatkowski F, Sugarbaker PH et al (2004) Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol 22:3284–3292

    Article  PubMed  CAS  Google Scholar 

  30. Hirose K, Katayama K, Iida A et al (1999) Efficacy of continuous hyperthermic peritoneal perfusion for the prophylaxis and treatment of peritoneal metastasis of advanced gastric cancer: evaluation by multivariate regression analysis. Oncology 57:106–114

    Article  PubMed  CAS  Google Scholar 

  31. Fujimoto S, Takahashi M, Mutou T et al (1997) Improved mortality rate of gastric carcinoma patients with peritoneal carcinomatosis treated with intraperitoneal hyperthermic chemoperfusion combined with surgery. Cancer 79:884–891

    Article  PubMed  CAS  Google Scholar 

  32. Elias D, Blot F, El Otmany A et al (2001) Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy. Cancer 92:71–76

    Article  PubMed  CAS  Google Scholar 

  33. Elias D, Raynard B, Bonnay M, Pocard M (2006) Heated intra-operative intraperitoneal oxaliplatin alone and in combination with intraperitoneal irinotecan: pharmacologic studies. Eur J Surg Oncol 32:607–613

    Article  PubMed  CAS  Google Scholar 

  34. Esquis P, Consolo D, Magnin G et al (2006) High intra-abdominal pressure enhances the penetration and antitumor effect of intraperitoneal cisplatin on experimental peritoneal carcinomatosis. Ann Surg 244:106–112

    Article  PubMed  Google Scholar 

  35. Sugarbaker PH, Mora JT, Carmignani P, Stuart OA, Yoo D (2005) Update on chemotherapeutic agents utilized for perioperative intraperitoneal chemotherapy. The Oncologist 10:112–122

    Article  PubMed  CAS  Google Scholar 

  36. Urano M, Kuroda M, Nishimura Y (1999) For the clinical application of thermochemotherapy given at mild temperatures. Int J Hyperthermia 15:79–107

    Article  PubMed  CAS  Google Scholar 

  37. Los G, Tuyt L, van Vugt M et al (1993) Combination treatment of cis- and carboplatin in cancers restricted to the peritoneal cavity in the rat. Cancer Chemother Pharmacol 32:425–433

    Article  PubMed  CAS  Google Scholar 

  38. Knutsen A, Sielaff TD, Greeno E, Tuttle TM (2006) Staged laparoscopic infusion of hyperthermic intraperitoneal chemotherapy after cytoreductive surgery. J Gastrointest Surg 10:1038–1043

    Article  PubMed  Google Scholar 

  39. Chang E, Alexander HR, Libutti SK et al (2001) Laparoscopic continuous hyperthermic peritoneal perfusion. J Am Coll Surg 193:225–229

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General and Minimally Invasive Surgery, Centre Hospitalier Intercommunal (Poissy Medical Center), 10, rue de Champ Gaillard, 78303, Poissy Cedex, France

    Elie Chouillard, Toufic Ata, Léon Maggiori & Nada Helmy

  2. Department of Intensive Care Medecine, Centre Hospitalier Intercommunal (Poissy Medical Center), Poissy Cedex, France

    Bernard De Jonghe & Hervé Outin

  3. Department of Oncology, Centre Hospitalier Intercommunal (Poissy Medical Center), Poissy Cedex, France

    Yvan Coscas

Authors
  1. Elie Chouillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toufic Ata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bernard De Jonghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Léon Maggiori
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nada Helmy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yvan Coscas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hervé Outin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elie Chouillard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chouillard, E., Ata, T., De Jonghe, B. et al. Staged laparoscopic adjuvant intraperitoneal chemohyperthermia after complete resection for locally advanced colorectal or gastric cancer: a preliminary experience. Surg Endosc 23, 363–369 (2009). https://doi.org/10.1007/s00464-008-9946-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-9946-4

Keywords

Search

Navigation