Peritoneal carcinomatosis unit
Hospital el Pilar Quirón Salud is the first private centre of Barcelona with a Unit specialized in Peritoneal Carcinomatosis, directed by the oncologic surgeons Dr. François Quénet and Juan José Torrent.
Peritoneal carcinomatosis is a form of intraabdominal dissemination of cancer of gastrointestinal, gynaecologic or peritoneal origin and is diagnosed by the presence of tumour nodes on the peritoneal surface. Peritoneal carcinomatosis is an advanced stage of primary tumours of the peritoneum such as the peritoneal mesothelioma or the pseudomyxoma peritonei, or secondary to a cancer of ovarian or digestive origin.
All the organs of the abdominal cavity – such as the stomach and the intestine– and the abdominal wall, are covered by a thin layer of cells; this layer is called “peritoneum”.
Until just recently, peritoneal carcinomatosis was considered as a terminal stage of the disease. The development of new surgical techniques to obtain a macroscopically complete resection of the disease has radically changed the prognosis of these entities. In certain cases, on finishing surgery, the treatment is completed with hyperthermic intraperitoneal chemotherapy (HIPEC) to enhance the benefit given by complete cytoreductive surgery.
Peritoneal Carcinomatosis is an advanced or metastatic stage of an abdominal cancer
The most common is the peritoneal cancer that originates from cells scattered through primary intra-abdominal tumour. The cells travel to the peritoneum and begin the grow on the peritoneal surface. With any primary tumour in the body this disease can be caused, but the abdominal organs, such as the colon, the stomach and the ovaries are the most common organs in origin.
Typically, the malignant cells will multiply and form small tumour nodules on the peritoneum.
This consists of the presence of mucus or mucoid material on the peritoneal surface. The most frequent cause of pseudomyxoma peritonei is the breakage of an appendicular tumour. Nowadays, thanks to complete cytoreductive surgery, combined with hyperthermic intraperitoneal chemotherapy (HIPEC), average survival has risen to more than 16 years.
Mesothelioma is a rare form of cancer derived from the mesothelium, which is the protective cover that covers most of the internal organs. Pleural mesothelioma is the most frequent and the most common cause is exposure to asbestos. The new surgical techniques such as peritonectomy to obtain a complete resection of the disease have radically changed the prognosis of this disease with high survival rates.
Ovarian cancer and primary peritoneal cancer
Ovarian cancer is the second most frequent among the gynaecologic cancers and the one with highest mortality. There exist different types of ovarian tumours according to the cell type, epithelial being the most frequent type. Primary peritoneal cancer is similar to and behaves like ovarian cancer, both being capable of producing peritoneal carcinomatosis. In both cases, the recommended treatment is surgery, followed by chemotherapy.
Colorectal cancer and colorectal carcinomatosis
50% of patients diagnosed with colorectal cancer will develop metastasis in the liver, the peritoneum, the lung, the bones or the brain. Nowadays, thanks to the development of new surgical techniques, the average survival has multiplied by 10 compared to spontaneous survival and by 3 compared to the most modern systemic chemotherapies.
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