Is Peritoneal Carcinomatosis an Incurable Disease or Controllable Locoregional Condition?
Takeshi Sano Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan Peritoneal carcinomatosis is the most common terminal feature of abdominal cancers. For gastrointestinal surgeons and medical oncologists, it is a vexing condition because, although the disease is limited to the peritoneal surface, complete surgical removal is impossible and systemic chemotherapy is powerless. Peritoneal carcinomatosis is generally considered to be an untreatable condition that makes clinicians abandon further aggressive treatments. Gynecologists have some different views on ovarian cancer. They have tried extensive debulking surgery for the peritoneal disease followed by intraperitoneal (i.p.) cisplatin-based chemotherapy. A large, randomized controlled trial has recently shown significant survival benefit of i.p. cisplatin as compared with intravenous cisplatin in patients with stage III ovarian cancer and residual tumor masses of 2 cm or less (1). This treatment strategy for ovarian
