Treatment of Primary Peritoneal Carcinosis of Digestive Origin Using Cytoreductive Surgery and Hyperthermic Intraoperative Peritoneal Chemotherapy With Mitomycin C and Irinotecan
- Patients with a peritoneal carcinosis (PC) either of digestive origin or primary: a
colorectal or gastric carcinosis, a peritoneal pseudomyxoma or mesothelioma, or a
primary carcinosis of the peritoneum regardless the number of prior treatment lines.
- A PC and primary tumor considered to be resectable according to preoperative clinical
and paraclinical data: absence of mesenteric retraction and absence of bladder
- Patients in good general health (ASA ≤ 2).
- Absence of cardiorespiratory failure (PaO2 > 60 mmHg in a stable condition, dyspnea
≤ NYHA stage 1, left ventricular ejection fraction > 60%.).
- Prothrombin level >70 %, total bilirubin < 2 x the normal level, ASAT and ALAT < 2.5
x normal levels, and alkaline phosphatases < 5 x normal levels.
- Creatinine clearance > 60 ml/min, polynuclear neutrophils > 1500/mm3, and a white
blood cell count > 4000 /mm3.
- Patients who give written, informed consent.
- Patients affiliated with the French universal healthcare system.
- Patients with a PC with ovarian, mammary, biliary, pancreatic, or bronchial origin.
- Evolutive patients after systemic chemotherapy.
- Patients with a PC considered to be irresectable according to preoperative clinical
and paraclinical data: mesenteric retraction or bladder invasion.
- Patients in poor general health (ASA > 2).
- Cardiorespiratory failure (dyspnea > NYHA stage 1, PaO2 < 60 mmHg in a stable
- Prothrombin level < 70 %.
- Any brain abnormality showing on the head scan.
- Signs of heart failure and especially left ventricular ejection fraction < 60% on the
- Thrombocytopenia < 100 000 / mm3
- Visceral metastases other than a single resectable liver metastasis.
- Pregnancy or breast feeding.
- Chronic inflammatory intestinal disease and/or an intestinal obstruction.
- History of severe hypersensitivity to irinotecan hydrochloride trihydrate or one of
the excipients of Campto.
- Bilirubinemia > 3 times the normal upper limit
- Yellow fever vaccine.
- Prophylactic treatment with phenytoin.
- Severe medullary insufficiency.