Peritoneal carcinomatosis is the metastatic phase of an abdominal cavity tumor: those located in the ovaries, colon, stomach or peritoneum. During this phase the expansion of malignant tumor nodules occurs. According to data from the Spanish Society of Medical Oncology (SEOM), “up to 35% of relapses in colon cancer affect the peritoneum”. Also 70% of stage III ovarian cancer diagnoses present with peritoneal carcinomatosis and up to 20% in the case of gastric cancers.
Experienced team of professionals to treat cancer
Faced with the growing need to provide a solution for these patients, the J. Torrent Institute Surgical Oncology starts the first Peritoneal Carcinomatosis Reference Unit in Barcelona, formed by a multidisciplinary team of internationally renowned surgeons, oncologists, radiologists, pathologists and specialists in gynecology and digestive system.
At the head of this Unit are Dr. Juan José Torrent, gynecologic oncologic surgeon, and Dr. François Quénet, digestive oncologic surgeon. Both specialists agree that peritoneal carcinomatosis gives the patient a worse prognosis and quality of life than other metastatic locations. It is therefore necessary for patients to be aware of the importance of surgical treatment, even though it is a complex operation that requires putting oneself in the hands of an experienced team.
According to data from the Spanish Society of Medical Oncology (SEOM), the incidence figures for peritoneal carcinomatosis are unknown, since the dissemination of a primary tumor is difficult to diagnose in its initial stages. For this reason, peritoneal carcinomatosis is considered a metastatic phase of a primary tumor. The tumors of primary origin with the highest incidence of peritoneal carcinomatosis are colon, ovarian, appendiceal, gastric and peritoneal cancer. Approximately 20-35% of patients with colon cancer will present peritoneal carcinomatosis, as well as 80% in ovarian cancer, 20% in gastric cancer initially and 30% in recurrences.
Intraperitoneal chemotherapy to increase survival in tumors with metastases
Cytoreduction surgery with intraoperative hyperthermic intraperitoneal intraperitoneal chemotherapy (HIPEC) is the best treatment combination. It consists of removing the tumor and the tumor implants with surgery and then applying chemotherapy at high temperature (42º C) inside the abdominal cavity. Forty percent of patients who undergo this treatment survive 5 years and 85% improve their quality of life and median survival.
The method of intraperitoneal chemotherapy in the form of an aerosol is Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): it reduces the volume of the tumor and can be followed by cytoreductive surgery or as palliative therapy. The PIPAC technique consists of intraperitoneal aerosol chemotherapy, so that the drugs penetrate and spread within the abdominal cavity in a homogeneous and localized manner.
The team of Dr. Torrent Correa is a pioneer in Spain in the PIPAC technique: “the contribution of PIPAC chemotherapy is that, even though it is considered an experimental technique, it offers an alternative to patients refractory to previous chemotherapies”. It is therefore considered a palliative treatment that offers good results in terms of quality of life: “Our patients who have undergone several sessions of PIPAC have a normal life. Since it is not possible to operate with curative intent, with this treatment they achieve a good quality of life,” says Dr. Torrent.