| Theme |
Advancement of Medical Practice for Peritonitis and Ascites |
| Title |
Pancreatic Ductal Adenocarcinoma with Peritoneal Metastasis |
| Author |
Sohei Satoi |
Department of Surgery, Kansai Medical University |
| Author |
Tomohisa Yamamoto |
Department of Surgery, Kansai Medical University |
| Author |
So Yamaki |
Department of Surgery, Kansai Medical University |
| Author |
Hisashi Kosaka |
Department of Surgery, Kansai Medical University |
| Author |
Satoshi Hirooka |
Department of Surgery, Kansai Medical University |
| Author |
Yoichi Matsui |
Department of Surgery, Kansai Medical University |
| [ Summary ] |
Peritoneal metastasis is associated with development of intestinal obstruction, massive ascites, and malnutrition, leading to poor performance status, which consequently serves as a contraindication for chemotherapy in these patients. Reportedly, the median survival time in patients with malignant ascites is 6-7 weeks. Intraperitoneal chemotherapy scores over systemic chemotherapy for the treatment of peritoneal dissemination because it achieves a high drug concentration in the peritoneal cavity for the drug to directly act on the tumor nodules. Various associated symptoms such as massive ascites, intestinal obstruction, and hydronephrosis are treated with cell-free and concentrated ascites reinfusion therapy, bypass procedures, and stenting among other such strategies. In this article, we review the clinical features, treatment strategies, and future perspectives for pancreatic ductal adenocarcinoma in patients with peritoneal metastasis. |