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Local recurrence and prognosis of abdominopelvic sarcomas depend on complete resection of the primary malignancy. Peritoneal seeding of the tumor can be assessed by the size of the tumor and the number of abdominopelvic regions involved by sarcoma. Under these conditions, we analyzed 14 consecutive patients with primary sarcoma. Complete resection of the tumor was performed in 9 patients with peritoneal involvement less than or equal to 3 abdomino-pelvic regions and complete resection combined with perioperative intraperitoneal chemotherapy was performed for the last 5 patient with involvement of more than 3 abdomino-pelvic regions. Results shows that the median survival was 28 months and the survival for very large tumors treated with perioperative intraperitoneal chemotherapy was similar to survival for smaller tumors treated by resection only. These results suggest the efficacy of chemotherapy on the site of resection and argue in favour of the use of regional chemotherapy in an attempt to achieve long-term disease-free survival for primary sarcoma.

The natural history of surgically treated intraabdominal malignancy is such that a large proportion of patients present tumor recurrence at wound sites. Numerous factors operating within the wound environment are important determinants in tumor cells arrest or growth at these sites. This article describes the interactions between the traumatized tissues and tumor cells, and attempts to understand the important factors that may have an impact on implantation of cancer cells in wound sites. Modifications of these biologic factors may represent new perspectives for preventing tumor recurrence in intraabdominal wound sites.