The European contribution to "Sugarbaker's protocol" for the treatment of colorectal peritoneal carcinomatosis.

Introduction: In 1981, Dr. PH Sugarbaker, challenging oncological orthodoxy, considered carcinomatosis to be a locoregional stage of the disease that was still susceptible to treatment with curative intent. To this end he developed a new therapeutic alternative based on the combined treatment.

[Prevalence and treatment of oncologic disease in the elderly --an impeding challenge].

Life expectancy in Spain has more than duplicated during the last 20th Century, and is currently 75 years for men and 83 years for women. Predictions on the evolution of the National and global population anticipate a demographic shock in Spain when individuals older than 65 years eventually make up more than 33.5% of the Spanish population by year 2050.

[Open vacuum-pack abdomen. An ideal technique for deferred temporary abdominal closure in complications after cytoreduction surgery and intraperitoneal chemotherapy with hyperthermia due to peritoneal cancer].

Introduction: The use of a new therapeutic alternative involving cytoreductive surgery with perioperative intraperitoneal chemotherapy in the treatment of patients suffering from peritoneal carcinomatosis represents a new challenge for the multidisciplinary teams caring for these patients. Their post-operative progress and care needs, apart from differing from those of conventional patients, have not yet been completely defined or protocolised. In this presentation we explain the special characteristics of these patients compared to the usual surgical patients, the possible physiopathological mechanisms which may give rise to the different types of complications, the circumstances when a temporary abdominal closure is necessary, the ideal conditions required for an optimal technique, and finally our experience with the open vacuum abdomen technique in the treatment of the complications that appear in patients treated by this new triple combined therapy.

[Malignant peritoneal mesothelioma. Our experienced with triple combined therapy: cytoreduction, intraperitoneal perioperative chemotherapy and hyperthermia].

Introduction: Malignant peritoneal mesothelioma is the most common primary neoplasm of the serous peritoneum. Most patients die of the complications of local disease confined to the peritoneal cavity, while nodal or distant dissemination is extremely rare. Prognosis with traditional therapeutic options is dismal, with a median survival of between 4 and 12 months from diagnosis.

[Hepatic portal venous gas. Clinical significance and review of the literature].

Hepatic portal venous gas in adults is a rare entity. The most frequent cause is intestinal ischemia. However, an increasing number of cases associated with benign conditions suitable for conservative treatment are being reported.

[Principles of the treatment of peritoneal carcinomatosis due to colorectal cancer. Current review and update].

Colorectal cancer is the most frequent digestive tumor. The incidence of abdominal dissemination is high and all studies of the natural history of colorectal carcinomatosis demonstrate that prognosis in these patients is poor, with a mean survival of between 5 and 9 months. Furthermore, the results of systemic adjuvant treatment are disappointing, with a maximum survival of 18 months.

Peritoneal carcinomatosis of colorectal origin. Current treatment. Review and update.

Colorectal cancer is the most frequent tumor of the digestive tract. The high incidence of abdominal dissemination; the poor prognosis of these patients, with median survival consistently ranging from 5 to 9 months in all studies of peritoneal carcinomatosis from colorectal cancer; the failure of adjuvant systemic chemotherapy treatment with a maximal survival of 18 months despite the development of new cytostatic drugs, and new combinations of use, make it crucial to search for and develop new treatment strategies. We review the principles of Sugarbaker s treatment protocol, which involves the combination of maximum cytoreductive radical oncological surgery for the treatment of all macroscopically disseminated disease with maximum perioperative intraperitoneal intensification chemotherapy to treat residual microscopic disease.

[Incidence of bacteremia among histologic groups of hematologic malignancies].

Introduction: Subgroups having dissimilar prognoses are being identified among cancer patients with infection. Previous studies have suggested that these differences may be related to the histologic diagnosis, but this issue has not as yet been demonstrated.

Methods: We reviewed the medical records of all patients admitted with acute leukemia (AL) or lymphoma (ML) from 1988 to 1998.

[Incidence of lymphoid neoplasms in patients with HIV infection].

Background: The incidence, histologic type and clinical characteristics of the lymphoid neoplasms found in patients with HIV infection may be influenced by environmental factors. These characteristics were herewith investigated in the authors medium.

Methods: The medical records of the patients in whom lymphoma was diagnosed were reviewed studying the usual clinical, epidemiological, histological and biological variables.

Effects of triflusal in patients with prosthetic heart valves.

The biological effects of a new antiplatelet agent, triflusal, were evaluated in patients with cardiac valvular prostheses. Each patient received 900 mg/day of oral triflusal for 30 days. Triflusal significantly inhibited platelet aggregation induced by adenosine diphosphate (1 to 5 mumol) or epinephrine (12.