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Hyperthermic intraperitoneal chemotherapy as palliative treatment for malignant ascites A single-center experience and a review of the literature.

Abstract：

:Malignant ascites is an abnormal accumulation of fluid in the peritoneal cavity of patients with intraperitoneal cancer dissemination. This clinical condition could represent the terminal evolution of a lethal disease and could influence the prognosis, severely impairing the patients' quality of life. Treatment options include a multitude of different procedures with limited efficacy and some degree of risk; diuretics, paracentesis, peritoneo-venous shunts and intraperitoneal biologic agents like anti-VEGF molecules, metalloproteinase inhibitors and immunomodulators are included. None of these approaches have been established as a standard of care because of their low efficacy or severe side effects. The last two decades saw the emergence of cytoreductive surgery with hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) as a viable therapeutic approach resulting in an effective cure against refractory malignant ascites. The following describes our experiences with 3 cases together with a literature review. KEY WORDS:Chemotherapy, HIPEC, Laparoscopy, Malignant ascites. :L’ascite maligna rappresenta il quadro avanzato di anormale accumulo di liquido intraperitoneale in pazienti con carcinosi peritoneale. Questa condizione clinica può rappresentare la condizione terminale di questa patologia a pessima prognosi inficiando inoltre la qualità di vita dei pazienti. Le opzioni terapeutiche includono differenti procedure che hanno tuttavia una limitata efficacia e alcune criticità; diuretici, paracentesi, shunt veno-peritoneali, inibitori delle metallo proteasi, immunomodulatori e agenti biologici rappresentano alcuni esempi di queste procedure. Nessuno di questi approcci terapeutici rappresenta a oggi lo standard of care per questa patologia data la scarsa efficienza e l’alto grado di effetti collaterali. L’introduzione della chirurgia citoriduttiva e della chemio terapia ipertermica intraperitoneale sembra essere un approccio terapeutico valido nel trattamento dell’ascite maligna refrattaria, introdotto nelle ultime due decadi e che tutt’ora necessita di validazione scientifica. In questo lavoro condividiamo la nostra esperienza di tre casi affetti da ascite maligna refrattaria trattati con HIPEC; facciamo inoltre una revisione della letteratura.

journal_name

Ann Ital Chir

journal_title

Annali italiani di chirurgia

authors

Graziosi L,Marino E,De Angelis V,Rebonato A,Donini A

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

312-320

eissn

0003-469X

issn

2239-253X

pii

S0003469X1602412X

journal_volume

87

pub_type

杂志文章

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