Madrid, April 29, 2021 - Palliative surgery in peritoneal carcinomatosis can mean months of difference in the survival rate of patients and with improved quality of life. “In peritoneal disease caused by colon cancer where the average survival rate of patients is up to 16 months, PIPAC (intraperitoneal administration of aerosolized chemotherapy) used as a palliative treatment can increase survival rates by up to 42 months in selected patients who meet certain criteria”, Says Dr. Santiago Gonzalez Moreno, medical director and head of the Surgical Oncology and General and Gastrointestinal Surgery Service at MD Anderson Cancer Center Madrid.
Tumors with peritoneal dissemination are those that spread to and develop in the peritoneum (the inner layer that covers the abdomen and interior of the pelvis and their organs). They can be tumors of different origin (ovarian cancer, stomach cancer, colon cancer, appendix cancer, etc.) or they can be primary tumors of the peritoneum, such as mesothelioma.
The most common treatment is cytoreductive surgery combined with HIPEC, a curative surgery, where all macroscopic tumor implants seen in the abdomen are removed, which is then combined with chemotherapy applied directly to the open abdomen, which is ‘filled' with a warm chemotherapy solution (up to 41 or 42ºC).
However, up to 40% of patients with peritoneal carcinomatosis do not qualify for cytoreduction surgery with HIPEC. "We have to be able to offer these patients an alternative that allows them to prolong their life with good quality, avoiding intestinal obstructions and an accumulation of fluid in the abdominal cavity, or ascites", explains the specialist.
This is achieved by PIPAC, a palliative technique that administers aerosolized chemotherapy intraperitoneally by means of laparoscopic surgery and which offers new treatment options to patients with unresectable peritoneal carcinomatosis; that is, with metastases in the peritoneum, and who are not candidates for curative surgical treatment. "It is about being able to offer the patient, at any stage and whatever the form their disease takes, a solution that can help them, both curatively and palliatively," he adds. In fact, he goes on to say, "at MD Anderson Madrid substantial research is being done on palliative treatments using intraperitoneal chemotherapy for these patients." At present, it is the only private hospital offering the technique in Madrid and one of the few in Spain.
The Multidisciplinary Peritoneal Oncology Unit at MD Anderson Madrid (made up of medical, surgical and radiotherapy oncologists, radiologists, pathologists, as well as specialists from a variety of other medical fields) offers 360-degree treatment for this pathology. “We have all the avante-guard therapeutic equipment needed to treat patients with malignant peritoneal disease of various origins in all its phases, from the earliest to the most advanced. Few hospitals in Spain can offer these patients such a comprehensive approach, with effective multidisciplinary coordination”, states Dr. Gonzalez-Moreno.