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Combining surgery with novel treatment may improve survival rates

Winston-Salem, N.C. Researchers at Wake Forest University Baptist Medical Center report in the February issue of Annals of Surgical Oncology that surgery combined with inserting heated chemotherapy drugs directly into the abdomen can improve survival rates and quality of life in patients with cancer of the abdominal cavity that has spread from the colon.

Patients participating in the research study had a median overall survival of 16 months, with 17 percent surviving five years or more. Traditionally, patients with this condition, called peritoneal carcinomatosis, survive only 3 to 6 months without treatment.

Peritoneal cancer is the most common cause of death in patients with cancers in the abdomen. Surgery alone has proven to be ineffective, as have external beam radiation therapy, brachytherapy and systemic chemotherapy.

Perry Shen, M.D., assistant professor of surgical oncology, was lead author of the study, which involved a retrospective review of 77 patients between 1991 and 2002 with peritoneal disease that had spread from colorectal cancer.

"As surgical techniques and perioperative care have improved, there has been a greater trend towards more aggressive surgical treatment of solid tumors," said Shen. "This study, combined with reports from other institutions, indicates that selected patients can achieve long- term survival with complete removal of peritoneal disease from colorectal cancer, which is the second leading cause of cancer death in the United States."

All patients underwent surgery to remove as much of the tumor and surrounding cancerous tissue as possible, followed immediately with a treatment called intraperitoneal hyperthermic chemotherapy (IPHC). With IPHC, the patient's core temperature was cooled to just over 93 degrees Fahrenheit. Immediately after surgery, catheters were placed in the abdomen to deliver the chemotherapy directly into the abdominal cavity. The chemotherapy agent, heated to a maxim
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Contact: Jonnie Rohrer
jrohrer@wfubmc.edu
336-716-4587
Wake Forest University Baptist Medical Center
9-Feb-2004


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