Peritoneal tumors – a rare but very serious oncological disease

Corresponds to general statistics

« According to the National Cancer Center (NVC), the frequency of these tumors in Lithuania corresponds to global statistics, » says dr. Giedrė Rudinskaitė.

She explains that peritoneal tumors are divided into primary and metastatic.

« Primary peritoneal malignancies are formed from the peritoneal tissue itself (peritoneal mesothelioma, peritoneal serous carcinoma). These malignancies are really rare. For example, the prevalence of peritoneal mesothelioma is only 1-3 cases of 1 million inhabitants, million, ”says G. Rudinskaitė.

Metastic peritoneal tumors develop in the peritoneum of metastasis of other localities, such as worm growth, colon, stomach, fallopian tubes or ovary. In all cases, these crayfish are metastatic into the peritoneum or other organs – usually depending on the stage of the disease the patient has been treated. In the early stages of the disease, metastases can also be healed in the peritoneum or parenchymal organs (solid organs, such as kidneys or liver). However, when the advanced stage 3-4 ovarian cancer is detected, about 70 % of the metastases peritoneal are found. cases. When diagnosing colon cancer, the probability of metastases in the peritoneum is about 20 percent.

The golden standard of the primary peritoneal and worm tumors is the citreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). It is the most effective method currently used in the world. Cijereductive surgery and HIG can also be applied to some ovarian cancer, colon and stomach cancer in the metastatic peritoneal. Treatment tactics are always discussed and selected during the multidisciplinary council.

Giedrė Rudinskaitė / Photo by Personal Archive

The reasons remain unclear

The causes of malignant tumors are unclear. The risk of developing peritoneal mesothelioma is known to increase the risk of asbestos. Risk factors should also include harmful habits, chronic inflammatory diseases, genetic predisposition – risk factors that increase the likelihood of developing other forms of cancer.

« In the initial stages of the disease, no symptoms are commonplace or very mild, non -specific. When the disease progresses, the abdomen begins to produce fluid, abdominal scraping and pain, tiredness and weakness may occur. G. Rudinskaitė tells about the symptoms of the disease.

Different tests – ultrasound, computed tomography, magnetic resonance – can be performed to find out what the cause of the perceptible or visible symptoms is, but tumor biopsy required for the final approval of the tumor tumors. To this end, diagnostic laparoscopy or biopsy is taken with ultrasound control transkutanically. This allows you to determine the origin of the peritoneal change – primary peritoneal cancer or metastases from another organ.

« Unlike most other crayfish, peritoneal cancer is not classified according to TNM’s classification of malignant tumors into stages, but this form of cancer is aggressive – clinicians may take just 1-2 years or less from the onset of disease to death, » says NVC Abdominal Surgery. The average survival rate for patients is six months without treatment.

Modern method

Once the primary peritoneal tumors, and sometimes ovarian cancer, colon or stomach cancer metastases, are commonly performed, a citreductive surgery is usually performed. This operation aims to eliminate all the tumor lesions visible to the eye, or, if necessary, the surrounding lymph nodes, the entire peritoneal or part of it, the abdominal organs covered by the spread of the tumor. It is one of the largest and most complex surgery in the abdominal cavity with an average duration of about 7 hours.

However, even after the tumor has been completely removed, the abdominal cavity can remain cancerous cells that are invisible to the eye. For more than a decade, the disease has been performed in Lithuania for more than a decade to prevent the disease from renewing or spreading into other organs, hyperthermic intraperitoneal chemotherapy (HIPEC) has been performed. In the world, this methodology has been applying for over 50 years. G. Rudinskaitė went into this methodology and worked at it at a year -long internship in France at the Montpelier Cancer Institute and is successfully applied by the NVC.

« HIG is performed by pouring a diluted and warmed chemotherapy into the abdominal cavity, where the drug circulates to maintain the required temperature of 41-42 ° C. A special apparatus is used for the procedure to provide chemotherapy circulation and temperature maintaining. It is more sensitive to the medicine being prescribed, ”says G. Rudinskaitė.

The NVC is performed with an open HIGHCE methodology, where the chemistry circulates after the surgery before the abdominal cavity, which allows the medication to be more evenly distributed and ensure the same temperature in all parts of the abdomen. The HIPEC procedure itself takes 30 to 90 minutes.

Primary peritoneal malignant tumors are formed from the peritoneal tissue itself.

Less side effects

The oncologist chemotherapist, after evaluating the patient’s clinical situation and treating the patient as effective as possible, may prescribe one treatment for a specific cancer or a combination of several drugs. Intraperitoneal hyperthermic chemotherapy is commonly used for the same medication that is administered intravenously to the treatment of various localization tumors – platinum preparations, mitomycin C, doxorubicin.

« Importantly, intraperitoneal hyperthermal chemotherapy drugs are located locally in the abdominal cavity, so this type of chemotherapy has less side effects than systemic intravenous chemotherapy. Nadezhda Lachej.

However, HIPEC is not the only possible treatment method with peritoneal tumors. The doctor points out that several different treatment methods – surgery, chemotherapy, and less frequently immunotherapy, cancer targets or radiation therapy – are usually applied to the development of a cancer treatment plan. What treatment to apply is decided by a whole team of specialists.

« The HIPEC method can also be combined with other cancer treatments, such as systemic anticancer medication. If there is a high risk of relapse after surgery, postoperative chemotherapy may be recommended for the patient. to improve the quality of life of patients, ”says Lachej.

NVC has already undergone 50 radical operations along with hyperthermic abdominal chemotherapy.