The management of peritoneal carcinomatosis at the Washington Cancer Institute combines intraoperative, early postoperative, and bidirectional long-term chemotherapy. In the operating room HIPEC is used. Then, if the patient's condition is stable, moderate dose intraperitoneal paclitaxel is used for 5 days. In most patients we place an intraperitoneal port. Over the course of the next six months combined intraperitoneal pemetrexed (Alimta) and systemic cisplatin are administered as tolerated by the patient. With this combined approach local-regional control has been excellent.
--Paul H. Sugarbaker, MD, FACS, FRCS, Washington Hospital Center