摘要
The peritoneal parietal and visceral surfaces of the abdomen and pelvis are an important anatomic site for the dissemination of epithelial ovarian cancer(EOC). The transcoelomic spread of cancer cells gives rise to peritoneal carcinomatosis(PC) which, without special treatments, is a fatal manifestation of EOC. In order to control PC cytoreductive surgery to remove macroscopic disease is combined with perioperative intraperitoneal(IP) and perioperative intravenous chemotherapy to eradicate microscopic residual disease. Chemotherapy agents are selected to be administered by the IP or intravenous route based on their pharmacologic properties. A peritoneal-plasma barrier which retards the clearance of high molecular weight chemotherapy from the peritoneal cavity results in a large exposure of small cancer nodules on abdominal and pelvic surfaces. Tissue penetration is facilitated by moderate hyperthermia(41-42 ℃) of the IP chemotherapy solution. Timing of the chemotherapy as a planned part of the surgical procedure to maximize expo-sure of all peritoneal surfaces is crucial to success.
The peritoneal parietal and visceral surfaces of the ab-domen and pelvis are an important anatomic site for the dissemination of epithelial ovarian cancer （EOC）. The transcoelomic spread of cancer cells gives rise to peritoneal carcinomatosis （PC） which, without special treatments, is a fatal manifestation of EOC. In order to control PC cytoreductive surgery to remove macroscopic disease is combined with perioperative intraperitoneal （IP） and perioperative intravenous chemotherapy to eradicate microscopic residual disease. Chemotherapy agents are selected to be administered by the IP or intra-venous route based on their pharmacologic properties. A peritoneal-plasma barrier which retards the clearance of high molecular weight chemotherapy from the peritoneal cavity results in a large exposure of small cancer nodules on abdominal and pelvic surfaces. Tissue penetration is facilitated by moderate hyperthermia （41-42 ℃） of the IP chemotherapy solution. Timing of the chemotherapy as a planned part of the surgical procedure to maximize exposure of all peritoneal surfaces is crucial to success.
作者
Kurt Van der Speeten
Anthony O Stuart
Paul H Sugarbaker
Kurt Van der Speeten;Anthony O Stuart;Paul H Sugarbaker(Department of Surgical Oncology, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium;University Hasselt, Life Sciences Faculty, Oncology Research Cluster, 3000 Hasselt, Belgium;Washington Cancer Institute, Washington Hospital Center, Washington, DC 20010,United States)
