Peritoneal carcinomatosis in ovarian cancer: treatment, prognosis and survival

Malignant neoplasm of the ovary is a common disorder that affects women of all ages. Peritoneal carcinomatosis in ovarian cancer is considered to be of secondary pathology, significantly worsens the prognosis for recovery. With concomitant kantseromatoze often detected ascites requiring specific therapy.

What is peritoneal carcinomatosis

Peritoneal carcinomatosis - a consequence of the development of tumors and the spread of metastasis. Often peritoneal carcinomatosis occurs in ovarian cancer stage 3 and 4.

When kantseromatoze main tumor cell elements are separated to the extent of its growth and spread over the peritoneum with the flow of lymph and blood. The phenomenon is due to the loss of tumor cells adequate adhesion. 3 in ovarian cancer, ovarian carcinomatosis step 4 is observed in 40% of cases.

Peritoneal carcinomatosis considered adverse complication that accompanies ovarian cancer. This is due to the absence of surgical treatment options. Chemotherapy is only palliative.

Causes

Peritoneal carcinomatosis is a serious pathology. Its appearance is due to the development of malignant tumors, such as ovarian cancer.

Carcinomatosis, observed in the peritoneum, is gradual in nature:

1. Direct spread of tumor cells from the primary chamber, it becomes possible by the acquisition of mobility. There are also processes of matrix degradation. The spread of ovarian cancer cells can be carried out in an operation process in the case of vascular injury. Germination occurs in the cell area of ​​the cecum or in the pockets of Douglas.
2. The interaction of cells and peritoneal mesothelium. It notes the spread of horizontal cells and their invasive growth into the membrane and connective tissue.
3. Stimulation neangiogeneza. This condition is an important factor in the subsequent progression of ovarian cancer.

Important! Mechanisms of peritoneal carcinomatosis studied sufficiently.

Symptoms and classification

As it considered carcinomatosis secondary pathology, clinical picture caused by the passage of ovarian cancer. A feature called significant effusion, and ascites formation. Sometimes the only symptom is ascites, indicating the pathology of the peritoneum.

As a rule, the state of patients characterized as serious. Marked weight loss, nausea and vomiting, increasing weakness. Ovarian cancer specialist can test the individual metastases.

The general classification is not developed. Gynecologists suggest the following classification, which means the number, localization of metastases:

• P1. Local lesion area of ​​the peritoneum.
• P2. It noted several areas of peritoneal carcinomatosis, which are separated by healthy areas.
• P3. There are multiple foci.

Used also points summation method, in which the maximum measured lesions in the affected area.

Diagnostics

The clinical picture is no different specificity, which causes some difficulty in diagnosis. Typically, the diagnosis is confirmed by an oncologist after major studies:

• laboratory methods for determining increased ESR and leukocytosis;
• ultrasound of the pelvic organs helps to identify ovarian cancer.

In the presence of ascites fluid is required to carry out the analysis, it is possible through the implementation of paracentesis. Of considerable importance is laparoscopy, comprising inspection Douglas space, peritoneum and the diaphragm.

Important! In some cases there are difficulties in identifying the source of secondary pathology causes the small size of the malignant tumor. Determination of tumor markers level is not always informative.

Treatment of ovarian kantseromatoze

carcinomatosis treatment is a complex task. As a rule, specialists use a combination of several techniques.

Chemotherapy

The method has both advantages and disadvantages. The most effective way is the so-called intraperitoneal chemotherapy. This is due to the fact that in the case of local drug administration efficacy is increased. Especially, there is the possibility of using substances in high doses, it is often necessary to achieve treatment success.

Among the advantages of the method of experts called for quite a long presence of the drug in the peritoneal cavity. This type of chemotherapy or recommended for use during surgery or after its implementation.

Agent chemotherapy is necessary to warm up to 40-43 degrees. The solution is circulated around 90 minutes.

In modern Gynecology also used alternative methods of treatment, such as photodynamic therapy (Photodynamic therapy), which can be a local or systemic administration used photosensitizer. Impact is the direct participation of the laser system, damaging membrane of ovarian cancer cells. However, the effectiveness of the method is not material.

symptomatic therapy

Symptomatic or palliative therapy is the treatment of the auxiliary member. The need for its use is associated with pain relief and correction of psycho-emotional state. For this purpose are used anti-inflammatory and analgesic drugs, antidepressants, antianxiety agents and others. When violations of sleep shows a typical sleeping pills.

Treatment of primary focus

Peritoneal carcinomatosis - pathology secondary character. Specialist must identify the source of a malignant tumor. In gynecological practice cause kantsermatoza peritoneal ovarian cancer is often 3 or 4 stages.

treatment policy determined by the size and location of the tumor, the presence of metastasis. Normally treatment measures are complex and combine radiotherapy, chemotherapy and surgery. In some cases, the operation is not possible due to the nature of cancer. In order to apply intensive treatment beam radiation and chemotherapy.

Surgery

Within the surgical removal of a malignant tumor produce primary character. It is mandatory to excision of the regional lymph nodes and metastases formed. Sometimes ovarian cancer provokes ascites after surgery.

The surgical procedure depends on the extent of carcinomatosis of the peritoneum. In some cases of ovarian ablation, uterine appendages, gall bladder, and sigmoid colon.

Important! Surgery for ovarian cancer with ascites associated with a high risk of complications. In order to prevent recurrences of cancer chemotherapy.

complications

In the absence of early treatment of peritoneal carcinomatosis causes malignant tumor progression and spread of cancer cells. Certain complexity is the timely detection of the primary tumor, which often causes complications.

Ascites in ovarian cancer

Ascites called secondary pathology, in which there is an accumulation of liquid exudate (transudate) in the peritoneum. Often there is ascites in ovarian cancer and is associated with organ rupture. Complication indicates the malignant tumor 3, 4 stages.

The accumulation of liquid contents shown by increase in the total volume of the abdomen, bloating, weight. The patient experiences pain, shortness of breath marks, limitation of movement, false urges to urinate and defecate, vomiting and nausea. Complication can lead to the appearance of hernias, hemorrhoids, ulcers and hair loss.

Abdominal ascites of ovarian cancer at leads to an increase in pressure, the diaphragm dome marginalization to the thoracic cavity. There is a malfunction of the internal organs, the cardiovascular system. Of complications also produce cardiac and respiratory failure, metabolic disorders. Pathology may provoke lymphogenous spread of cancer cells and the formation of new metastases.

Attention! Sometimes there is ascites with ovarian cysts. In the early stages visually identify pathology is not possible. Necessary tool diagnosis which reveals ascites and treat ovarian cancer.

Peritoneal carcinomatosis in ovarian cancer: prognosis of survival

Ovarian cancer complicated carcinomatosis is a serious pathology. Although various embodiments of the combination treatment strategies, there is no effective method of complete cure. As a rule, after the treatment of cancer relapses. It is also associated with insufficient knowledge of the pathology.

Ovarian cancer stage 4, ascites - how many live

Malignant ovarian tumor of the last stage is considered a serious pathology with poor survival. Carcinomatosis, and ovarian cancer with ascites significantly worsen the prognosis. Usually stage 4 cancer observed multiple metastases representing islands of malignant cells.

Survival depends on the general state of the organism, the degree of involvement in Oncology process various organs. The median is 10%.

Ovarian Cancer Stage 3, ascites - how many live

Formation ovarian ascites has relatively favorable prognosis provided integrated timely treatment. In identifying metastases and peritoneal carcinomatosis chances considerably reduced. Typically, cancer survival does not exceed 50%.

conclusion

Peritoneal carcinomatosis of ovarian cancer requires a combination of therapeutic measures aimed at improving the survival and quality of life. Prognosis depends essentially on the timely detection of disease.