Intraperitoneal chemotherapy in disseminated abdominal sarcoma.

Abstract

There is no information in the literature concerning the use of cytoreductive surgery with intraperitoneal chemotherapy for sarcomas disseminated intraabdominally. A prospective study was initiated of exploratory laparotomy, removal of all macroscopic tumor when feasible, and intraperitoneal chemotherapy with cis-DDP 100 mg/m2 every 4 weeks. Patients were to be explored in 6 months or earlier for detectable tumor recurrence. Twenty-eight consecutive patients enrolled in the study. Complete resection of all macroscopic tumor was possible in 79% of patients. Survival rates at years 1-5 were 54%, 21%, 7%, 7%, and 7%, respectively. Of the two long-term survivors, one was found to be disease free at the second-look operation with a catheter free of adhesions, whereas the other had recurrent disease and all her lesions were resected. Of 20 patients who underwent a second-look procedure, the Tenkhoff intraperitoneal catheter was found to be densely surrounded by adhesions in 19. In the 19 patients with adhesions, there was no tumor around the catheter for a radius of 15-20 cm, but the rest of the peritoneal cavity contained multiple tumor nodules. Removal of all macroscopic tumor is possible in 79% of the patients with sarcoma disseminated in the abdominal cavity. Intraperitoneal chemotherapy with cis-DDP after cytoreductive surgery resulted in a 5-year survival rate of only 7%.