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Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy

Abstract

Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the gold standard in most patients. We describe electrochemotherapy (ECT), a minimally invasive method for locally-enhancing drug delivery by means of electric pulses, as an alternative approach. A 49-year-old man with advanced gastric cancer developed skin metastases around an ileostomy site. The ulcerated and oozing tumor growth impaired patient’s quality of life due to continuous trouble in fitting the ostomy appliance, its poor adherence and consequent stools spillage. ECT consisted of a 20-minute course under mild general sedation. A bleomycin bolus of 15 000 IU/m{sup 2} was followed by the percutaneous application of multiple, 1.5 ms -long electric pulses by means of a needle electrode. Post ECT course was uneventful and the patient was discharged on the same day. After one week, tumor nodules were flattened and partial tumor regression was appreciable at one-month follow-up. More importantly, peristomal skin conditions significantly improved, thus allowing for an effective application of the ostomy appliance during the following moths, until patient’s death. This report suggests the feasibility of ECT as a minimally invasive approach for peristomal tumors. In selected cases, ECT, by achieving a rapid tumor  More>>
Authors:
Campana, Luca G., E-mail: maximizing@hotmail.com; [1]  Scarpa, Marco; [2]  Sommariva, Antonio; [1]  Bonandini, Elena; [3]  Valpione, Sara; [4]  Sartore, Leonardo; [5]  Rossi, Carlo R. [1] 
  1. Sarcoma and Melanoma Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova (Italy)
  2. Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova (Italy)
  3. Department of Pathology, University of Padova, Padova (Italy)
  4. Melanoma Cancer Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova (Italy)
  5. Plastic Surgery Unit, University of Padova, Padova (Italy)
Publication Date:
Jan 01, 2013
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiology and Oncology; Journal Volume: 47; Journal Issue: 4; Other Information: PMCID: PMC3814282; PMID: 24294182; PUBLISHER-ID: rado-47-04-370; OAI: oai:pubmedcentral.nih.gov:3814282; Copyright (c) by Association of Radiology & Oncology; This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLEOMYCIN; CHEMOTHERAPY; DEATH; DELIVERY; DISEASE INCIDENCE; GOLD; LIVER; METASTASES; NEOPLASMS; PATIENTS; PULSES; SKIN; STANDARD OF LIVING; SURGERY
OSTI ID:
22345071
Country of Origin:
Slovenia
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1318-2099; TRN: SI15$0071051405
Availability:
Available from http://dx.doi.org/10.2478/raon-2013-0051; Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814282
Submitting Site:
INIS
Size:
page(s) 370-375
Announcement Date:
Jun 19, 2015

Citation Formats

Campana, Luca G., E-mail: maximizing@hotmail.com, Scarpa, Marco, Sommariva, Antonio, Bonandini, Elena, Valpione, Sara, Sartore, Leonardo, and Rossi, Carlo R. Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy. Slovenia: N. p., 2013. Web. doi:10.2478/RAON-2013-0051.
Campana, Luca G., E-mail: maximizing@hotmail.com, Scarpa, Marco, Sommariva, Antonio, Bonandini, Elena, Valpione, Sara, Sartore, Leonardo, & Rossi, Carlo R. Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy. Slovenia. doi:10.2478/RAON-2013-0051.
Campana, Luca G., E-mail: maximizing@hotmail.com, Scarpa, Marco, Sommariva, Antonio, Bonandini, Elena, Valpione, Sara, Sartore, Leonardo, and Rossi, Carlo R. 2013. "Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy." Slovenia. doi:10.2478/RAON-2013-0051. https://www.osti.gov/servlets/purl/10.2478/RAON-2013-0051.
@misc{etde_22345071,
title = {Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy}
author = {Campana, Luca G., E-mail: maximizing@hotmail.com, Scarpa, Marco, Sommariva, Antonio, Bonandini, Elena, Valpione, Sara, Sartore, Leonardo, and Rossi, Carlo R.}
abstractNote = {Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the gold standard in most patients. We describe electrochemotherapy (ECT), a minimally invasive method for locally-enhancing drug delivery by means of electric pulses, as an alternative approach. A 49-year-old man with advanced gastric cancer developed skin metastases around an ileostomy site. The ulcerated and oozing tumor growth impaired patient’s quality of life due to continuous trouble in fitting the ostomy appliance, its poor adherence and consequent stools spillage. ECT consisted of a 20-minute course under mild general sedation. A bleomycin bolus of 15 000 IU/m{sup 2} was followed by the percutaneous application of multiple, 1.5 ms -long electric pulses by means of a needle electrode. Post ECT course was uneventful and the patient was discharged on the same day. After one week, tumor nodules were flattened and partial tumor regression was appreciable at one-month follow-up. More importantly, peristomal skin conditions significantly improved, thus allowing for an effective application of the ostomy appliance during the following moths, until patient’s death. This report suggests the feasibility of ECT as a minimally invasive approach for peristomal tumors. In selected cases, ECT, by achieving a rapid tumor control, may ensure effective ostomy management and preserve patients’ quality of life.}
doi = {10.2478/RAON-2013-0051}
journal = {Radiology and Oncology}
issue = {4}
volume = {47}
journal type = {AC}
place = {Slovenia}
year = {2013}
month = {Jan}
}