Peritoneal carcinomatosis is a frequent sign of therapeutic failure in patients suffering from digestive and gynaecological cancer, and is often the form of appearance. Despite curative surgery, 20-30% of patients will develop a local recurrence. It has been classically considered as a sign of generalised disease and a therapeutic challenge, treated in a palliative way with an inevitably fatal outcome.
‘Sugarbaker’ technique doubles survival in colon cancer
The approach to cancer in a personalised medicine which focuses on the patient with a multidisciplinary approach, with treatments such as hyperthermic intraperitoneal chemotherapy (HIPEC), also known as the Sugarbakertechnique increases survival of patients with neoplasms spread into the abdominal cavity.
The technique developed by Dr. Paul H. Sugarbaker in 1982 considers the removal of the entire visible tumour and, subsequently, the perfusion of HIPEC (at 43o C) in the abdominal cavity to remove non-visible malignant cells, as heat enhances the effect of chemotherapy. This technique achieves survival outcome not recorded with any of the established treatments, reaching a rate of 50% in colon cancer at 5 years.
Treatment with HIPEC allows combining a high intensity of chemotherapy doses, focused on the affected area, with a lower systemic toxicity due to the limitation in the passage of the drug from the peritoneal cavity to the systemic torrent due to the characteristics of the peritoneal membrane and the drug itself. Its use requires highly qualified facilities with multidisciplinary teams and a degree of specialisation in oncological surgery as it is a very complex technique.