John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Peritoneal surface diseases Volume 21, issue 8, Octobre 2014


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1 Hospices Civils de Lyon,
CHU Lyon-Sud,
service de chirurgie générale,
oncologique et endocrinienne,
69495 Pierre Bénite, France
2 Hospices Civils de Lyon,
service de gynécologie,
Hôpital Femme Mère Enfant,
Bron, France ; EMR 3738, Université Lyon 1,
Lyon, France
* Tirés à part

Peritoneal tumors include mesenteric, greater omemtum tumors and peritoneal surface malignancies. Primitive mesenteric and peritoneal tumors are rare (pseudomyxoma peritonei, peritoneal mesothelioma, desmoplastic tumors and psammocarcinomas). Metastatic involvement of peritoneal serosa (peritoneal carcinomatosis) are more frequent and may be part of the evolution of many intraabdominal cancers (colorectal, stomach, pancreas, ovarian, appendix). Their prognosis depends on the primary tumor and disease extent or distribution evaluated by Peritoneal Cancer Index (PCI). Abdominopelvic scan remains the reference morphologic exam but the help of functional imaging (MRI and Pet-CT scan) is under evaluation. Laparoscopy is the most useful tool to appreciate the disease extent, the possibility of surgical resection and allows diagnostic biopsies. Historically, peritoneal carcinomatosis was regarded as the terminal stage of the disease, but the development of multidisciplinary locoregional therapeutic management that combined cytoreductive surgery and intraperitoneal chemotherapy with or without hyperthermia profoundly modify their prognosis and their management, to allow curative intent for limited and resectable disease. The development of prophylactic treatment for colorectal or gastric cancers at risk is under evaluation. These therapeutic strategies should be delivered into specialized centres but warrant new diagnostic and therapeutic reflexes