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1.1. The locoregional treatment of peritoneal surface malignancies has gained an increasing popularity thanks to favourable results in terms of outcome. However the procedure carries a significant morbidity, is time and resource consuming. This confirms the need for the establishment of a clear eligible criteria defining the potential indications of the method to assure a maximization of the prognostic gain, improvement of the quality of life and minimization of the side-effects. Which one of the following you do judge to be an absolute exclusion criteria for the procedure? (more than 1 alternative allowed)
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Presence of tumour mass > 5cm in the epigastric region evaluated by preoperative CT scan in peritoneal surface Malignancies (except Pseudomyxoma Peritonei); ([1])
First round: 37,50 % - Second round: 21,88 % |
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Class III of small bowel or small bowel mesentery evaluated by preoperative CT scan;(1)
First round: 68,75 % - Second round: 93,75 % |
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Obstruction of bowel segments, biliary tract or ureters;
First round: 37,50 % - Second round: 40,63 % |
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Tumor diameter greater than 0.5 cm on small bowel surfaces exclusive of distal ileum in mucinous peritoneal carcinomatosis; ([2])
First round: 12,50 % - Second round: 0 % |
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Presence of resectable liver metastases; ([3])
First round: 9,38 % - Second round: 21,88 % |
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Peritoneal cancer index >20 in colorectal cancer; ([4])
First round: 53,13 % - Second round: 62,50 % |
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Residual disease >2.5mm after the cytoreductive surgery.
First round: 46,88 % - Second round: 28,13 % |
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Gross retroperitoneal lymph node involvement
First round: 75,00 % - Second round: 90,63 % |
| [1] Yan TD, Haveric N, Carmignani CP, Chang D, Sugarbaker PH. Abdominal computed tomography scansin the selection of patients with malignant peritoneal mesothelioma for comprehensive treatmentwith cytoreductive surgery and perioperative intraperitoneal chemotherapy. Cancer. 2005 Feb 15;103(4):839-49. |
| [2] Jacquet P, Jelinek JS, Chang D, Koslowe P, Sugarbaker PH. Abdominal computed tomographic scan in the selection of patients with mucinous peritoneal carcinomatosis for cytoreductive surgery. J Am Coll Surg. 1995 Dec;181(6):530-8. |
[3] Elias D, Benizri E, Pocard M, Ducreux M, Boige V, Lasser P. Treatment of synchronous
peritoneal carcinomatosis and liver metastases from colorectal cancer. Eur J Surg Oncol.
2006 Apr 15; [Epub ahead of print] |
[4] Sugarbaker PH. Successful management of microscopic residual disease in large bowel cancer.
Cancer Chemother Pharmacol. 1999;43 Suppl:S15-25. Review. |
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