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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2011

01-01-2011 | Bone and Soft Tissue Sarcomas

Systematic Review on the Efficacy of Multimodal Treatment of Sarcomatosis with Cytoreduction and Intraperitoneal Chemotherapy

Authors: Gitonga Munene, MD, Lloyd A. Mack, MD, FRCSC, Walley J. Temple, MD, FRCSC, FACS

Published in: Annals of Surgical Oncology | Issue 1/2011

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Abstract

Background

Peritoneal sarcomatosis carries a dismal prognosis with median survival of 12 months and no 5-year survivors. The treatment for sarcomatosis has mostly been chemotherapy and surgery for palliation. Recently, cytoreduction (CRS) and intraperitoneal chemotherapy (IPC) has been tried as an alternative for improving regional control and survival, but the efficacy of this combined treatment is difficult to determine. The objective of this review is to evaluate all available evidence to determine the efficacy of this treatment modality.

Materials and Methods

Searches for studies published in peer-reviewed journals before October 2010 were carried out on 3 databases. The reference lists of all identified articles were reviewed for further relevant studies. Relevant studies were then evaluated by 3 investigators, and the quality of each study was assessed. Studies that met an established criterion were reviewed for clinical effectiveness with a tabulation of all results.

Results

Eight prospective and one randomized trial were available representing 240 patients treated with CRS and IPC. The median disease-free survival ranged from 2.3 to 22 months, median survival ranged from 5.5 to 39.6 months, and the 5-year survival ranged from 7% to 65%. The surgical morbidity varied from 9% to 44% and the mortality from 0% to 11%.

Conclusions

Based on the available data, this treatment approach is currently not recommended in the treatment of sarcomatosis except in experienced centers, in well-selected patients and as part of an experimental protocol.
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Metadata
Title
Systematic Review on the Efficacy of Multimodal Treatment of Sarcomatosis with Cytoreduction and Intraperitoneal Chemotherapy
Authors
Gitonga Munene, MD
Lloyd A. Mack, MD, FRCSC
Walley J. Temple, MD, FRCSC, FACS
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1229-3

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