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Combo Treatment Ups Survival When Cancer Spreads to Abdominal Lining
Date:3/14/2008

Studies found it made difference when disease moved from colon, appendix

FRIDAY, March 14 (HealthDay News) -- In certain patients with cancer that has spread to the peritoneum -- the membrane lining the abdominal cavity -- surgery combined with a special kind of chemotherapy can improve survival rates, Wake Forest University researchers report.

The findings are from one of two Wake Forest studies presented at this week's annual meeting of the Society of Surgical Oncology in Chicago.

The first study was a phase I trial to establish the maximum tolerated dose of oxaliplatin used in Intraperitoneal Hyperthermic Chemotherapy (IPHC) in treating colorectal and appendix cancers that have spread to the peritoneum. The 15-patient study found that IPHC at a dose of 200 mg/m is well-tolerated and is the maximum tolerated dose for a two-hour chemoperfusion.

"Based on the data from this phase I study, we propose to conduct a larger trial with oxaliplatin dose to study its efficacy in improving outcomes in patients with peritoneal carcinoma," Dr. John H. Stewart IV, an assistant professor of surgery in the section of surgical oncology, said in a prepared statement.

In the second study, researchers examined the use of IPHC in patients with peritoneal or hepatic metastases (HM), or liver malignancy that has spread from colorectal cancer. The study included 144 patients (17 with liver cancer) who had surgery to remove as much of the cancer as possible, followed by IPHC.

Median overall survival for those without HM was 22.7 months, compared to 15.8 months for those with HM. This was not a significant difference, the researchers said.

The study also found that two- and four-year survival rates for the HM patients were 34 percent and 11.3 percent. The presence of malignant fluid in the abdominal cavity was a significant predictor of decreased survival among patients with HM.

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