Welcome to surcicaloncology - helpful information about peritonealcarcinoses
Dr. med. Herwart Müller
Treatment strategy of the department of oncological surgery
Combination of different, new methods of treatment
It is aim of the department to put the different therapy modalities available and methods for an optimal treatment strategy for the patient together to be able to obtain an optimum to efficiency at a minimum to load for the patient. Chief attention is added to prepare a treatment plan for every single patient which is individual and not standardized simply only in which all therapy options like immune therapy, surgery or chemotherapy available are made use meaningfully.
The oncologic surgery offers a well unique variety of different and new therapy possibilities on high standard. So the most different treatment possibilities were brought together in the department to be at disposal by the patient.
These contain in particular:
- Systemic chemotherapy
- Inhibition of the chemical resistance
- Tumorous surgery
- Inductive reasoning therapy of primarily inoperable tumors
- Specific and non-specific immune therapy
- Geronto oncology
Treatment spectrum of the oncological surgery
All solid tumors of the body with the exception of the head and neck area, the bone as well as the ways of tumor from the area of the blood diseases have to be given therapy by the doctors from Hammelburg. The treatment spectrum of the therapy of the following ways of tumor contains :
- bronchogenic carcinoma
- small cell lung cancer
- non small cell lung cancer
- carcinoma of the mediastinum
- Larynx- / Pharynxrelapse
- esophageal carcinoma
- limb tumours
- malignant cholangioma
- pancreatic cancer
- gastric carcinoma
- colon carcinomas
- large bowel cancer
- rectum carcinoma
- Urolocical tumors incl. prostatacarcinoma
- renal carcinoma
- prostatic carcinoma
- gynecologic carcinomas
- cervical carcinoma
- epithelial ovarialcarcinoma
- vaginal cancer
- uterine sarcoma
- vulva carcinoma
- mamma carcinoma
- bone sarcoma
New publication about treatment of peritoneal metastasized gastric cancer
Systemic chemotherapy using FLOT – regimen combined with cytoreductive surgery plus HIPEC for treatment of peritoneal metastasized gastric cancer
Background. The aim was to evaluate the feasibility and the effectiveness of neoadjuvant systemic chemotherapy using FLOT - protocol followed by cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC) followed by systemic chemotherapyand in patients with peritoneal carcinomatosis (PC) from gastric cancer.
Material and methods. Twentysix (median age 53 years, range 39 - 71) were scheduled for three cycles of neoadjuvant systemic chemotherapy using bi-weekly FLOT - protocol followed by CRS + HIPEC. Thereafter 3 additional cycles of FLOT were given. During HIPEC in Colliseum technique Oxaliplatin was given in a dosage of 200 mg/m² and Docetaxel in a dosage of 80 mg/m².
Results. All patients underwent cytoreductive surgery plus HIPEC. Peritoneal Cancer index was > 15 in 3 cases only. Complete resection could be carried out in all cases (CC-O 18, CC-1 8). Postoperative complication rate was 23% with no mortality within 30 days. Anastomotic leakage rate was 3.2 %. Overall survival was 19.0 months with a 2-year survival rate 38 %. Regression analysis demonstrated a Peritoneal Cancer Index PCI > 12 as negative factor for survival.
Discussion. Neoadjuvant chemotherapy using FLOT - protocol followed by CRS + HIPEC seems to be associated with prolonged OS in patients with peritoneal carcinomatosis from gastric cancer. This treatment is not recommended for patients with extensive peritoneal involvement and PCI > 12.