Mucinous adenocarcinoma of the small bowel with peritoneal seeding

Aims: Small bowel adenocarcinoma has an extemely poor prognosis because of delayed diagnosis and the presence of advanced disease. Carcinomatosis associated with a small bowel primary cancer has not been reported to be successfully treated in the past. Methods: The clinical information prospectively recorded on six patients with carcinomatosis from small bowel adenocarcinoma was reviewed, All of these patients were treated with an aggressive local-regional strategy that utilized cytoreductive surgery plus peri-operative intraperitoneal mitomycin C and 5-fluorouracil. Results: Disease control in the abdomen and pelvis was achieved in four of these patients. Their median survival was 12 months with one patient alive and well at 4.5 years. Conclusions: Small bowel adenocarcinoma continues to provide a surgical challenge. Complete resection of all visible disease combined with intraperitoneal chemotherapy to eradicate microscopic residual disease should be considered as an option in patients with carcinomatosis. (C) 2002 Harcourt Publishers Ltd.