Publication: Ensayo clínico comparativo de técnica abierta vs ténica cerrada de quimioterapia intraoperatoria intraperitoneal hipertérmica en carcinomatosis de origen colorrectal
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2018-11-21
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Universidad Complutense de Madrid
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Abstract
Hasta hace pocos años la extensión peritoneal de los tumores que metastatizan en la cavidad abdominal ha sido considerada como una situación terminal e irresecable. Esta concepción de la enfermedad peritoneal como enfermedad oncológica sistémica se ha modificado en los últimos años gracias a los procedimientos de citorreducción (CR) + Quimioterapia hipertérmica intraperitoneal (HIPEC, Hyperthermic IntraPEritoneal Chemotherapy), pasando a considerarse en muchos casos como enfermedad loco-regional.En el caso concreto de la carcinomatosis peritoneal de origen colorrectal, la mediana de supervivencia con quimioterapia tradicional (5FU) es de 6’9 meses, mientras con quimioterapia contemporánea (basada en Oxaliplatino o Irinotecan) llega a 12’7 meses, muy inferior a la conseguida en las metástasis de otras localizaciones. Sin embargo el tratamiento mediante CR + HIPEC de los pacientes con enfermedad peritoneal limitada consigue supervivencias que oscilan entre 22 y 63 meses, con supervivencia a los 5 años de hasta un 50% en casos seleccionados...
Years ago the peritoneal disease was considered a terminal and unresectable situation. This conception of advanced oncologic disease has been modified by cytoreduction (CR) + hyperthermic intraperitoneal chemotherapy (HIPEC), which makes this situation a localized disease.Peritoneal carcinomatosis of colorectal cancer treated with systemic chemotherapy has a survival of 6 to 18 months, wether treatment by cytoreduction + HIPEC of peritoneal carcinomatosis of colorectal cancer in patients with limited resectable disease achieves a mean survival ranging from 22 to 63 months, with a 50% survival at five years.There are several techniques for the administration of hyperthermic intraperitoneal chemotherapy, of which the most commonly used are open technique (or "Coliseo" technique) and the closed technique. The most frequently used technique is the open technique but no studies have been performed to demonstrate an advantage of one over the other...
Years ago the peritoneal disease was considered a terminal and unresectable situation. This conception of advanced oncologic disease has been modified by cytoreduction (CR) + hyperthermic intraperitoneal chemotherapy (HIPEC), which makes this situation a localized disease.Peritoneal carcinomatosis of colorectal cancer treated with systemic chemotherapy has a survival of 6 to 18 months, wether treatment by cytoreduction + HIPEC of peritoneal carcinomatosis of colorectal cancer in patients with limited resectable disease achieves a mean survival ranging from 22 to 63 months, with a 50% survival at five years.There are several techniques for the administration of hyperthermic intraperitoneal chemotherapy, of which the most commonly used are open technique (or "Coliseo" technique) and the closed technique. The most frequently used technique is the open technique but no studies have been performed to demonstrate an advantage of one over the other...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 18/09/2017