Paul H. Sugarbaker, MD, FACS, FRCS, chief of the peritoneal surface malignancy program and director of the Center for Gastrointestinal Malignancies at MedStar Washington Hospital Center, discusses the use of perioperative chemotherapy in the treatment of patients with gastrointestinal (GI) cancer.

The effect of systemic chemotherapy differs between malignancies, explains Sugarbaker. Patients with GI cancer do not respond as well to systemic chemotherapy as those with breast cancer or melanoma. Approximately 25% of patients with GI cancer will experience an extended benefit from systemic chemotherapy, says Sugarbaker. In order to improve response rates, physicians recommend intensified doses of chemotherapy to increase the locoregional effects of the drug.

This approach is commonly known as intraperitoneal chemotherapy, says Sugarbaker. This is an approach that can be incorporated into the treatment of multiple malignancies, either intravenously with drugs such as cisplatin or intraperitoneally with drugs like pemetrexed. Physicians can ensure a better response as a result of these perioperative and postoperative strategies, concludes Sugarbaker, all the while controlling peritoneal metastases.

Paul H. Sugarbaker, MD, FACS, FRCS

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Dr. Sugarbaker on Perioperative Chemotherapy in Gastrointestinal Cancer