Recurrence of pseudomyxoma peritonei after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
Adult
Aged
Combined Modality Therapy
/ methods
Cytoreduction Surgical Procedures
/ methods
Disease-Free Survival
Female
Follow-Up Studies
Humans
Hyperthermia, Induced
/ methods
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Recurrence, Local
/ diagnosis
Peritoneal Neoplasms
/ mortality
Peritoneum
/ pathology
Prognosis
Prospective Studies
Pseudomyxoma Peritonei
/ mortality
Retrospective Studies
Time Factors
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
18
05
2018
accepted:
05
07
2018
entrez:
9
4
2019
pubmed:
9
4
2019
medline:
9
4
2019
Statut:
epublish
Résumé
Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by mucinous ascites, typically related to appendiceal or ovarian tumours. Current standard treatment involves cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), but recurrences occur in 20-30 per cent of patients. The aim of this study was to define the timing and patterns of recurrence to provide a basis for modifying follow-up of these patients. This observational study examined a prospectively developed multicentre national database (RENAPE working group) to identify patients with recurrence after optimal CRS and HIPEC for PMP. Postoperative complications, long-term outcomes and potential prognostic factors were evaluated. Of 1411 patients with proven PMP, 948 were identified who had undergone curative CRS and HIPEC. Among these patients, 229 first recurrences (24·2 per cent) were identified: 196 (20·7 per cent) occurred within the first 5 years (early recurrence) and 30 (3·2 per cent) occurred between 5 and 10 years. Three patients developed a first recurrence more than 10 years after the original treatment. The mean(s.d.) time to first recurrence was 2·36(2·21) years. Preoperative chemotherapy and high-grade pathology were significant factors for early recurrence. Overall survival for the entire group was 77·9 and 63·1 per cent at 5 and 10 years respectively. The principal site of recurrence was the peritoneum. Recurrence of PMP was rare after 5 years and exceptional after 10 years.
Sections du résumé
Background
Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by mucinous ascites, typically related to appendiceal or ovarian tumours. Current standard treatment involves cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), but recurrences occur in 20-30 per cent of patients. The aim of this study was to define the timing and patterns of recurrence to provide a basis for modifying follow-up of these patients.
Methods
This observational study examined a prospectively developed multicentre national database (RENAPE working group) to identify patients with recurrence after optimal CRS and HIPEC for PMP. Postoperative complications, long-term outcomes and potential prognostic factors were evaluated.
Results
Of 1411 patients with proven PMP, 948 were identified who had undergone curative CRS and HIPEC. Among these patients, 229 first recurrences (24·2 per cent) were identified: 196 (20·7 per cent) occurred within the first 5 years (early recurrence) and 30 (3·2 per cent) occurred between 5 and 10 years. Three patients developed a first recurrence more than 10 years after the original treatment. The mean(s.d.) time to first recurrence was 2·36(2·21) years. Preoperative chemotherapy and high-grade pathology were significant factors for early recurrence. Overall survival for the entire group was 77·9 and 63·1 per cent at 5 and 10 years respectively. The principal site of recurrence was the peritoneum.
Conclusion
Recurrence of PMP was rare after 5 years and exceptional after 10 years.
Identifiants
pubmed: 30957067
doi: 10.1002/bjs5.97
pii: BJS597
pmc: PMC6433307
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Pagination
195-202Investigateurs
J Abba
(J)
K Abboud
(K)
M Alyami
(M)
C Arvieux
(C)
G Averous
(G)
N Bakrin
(N)
G Balagué
(G)
V Barrau
(V)
H Ben Rejeb
(H)
J M Bereder
(JM)
I Berton Rigaud
(I)
F Bibeau
(F)
I Bonnefoy
(I)
D Bouzard
(D)
I Bricault
(I)
C Caramella
(C)
S Carrère
(S)
C de Chaisemartin
(C)
M Chassang
(M)
A Chevallier
(A)
T Courvoisier
(T)
P Dartigues
(P)
A Dohan
(A)
C Eveno
(C)
M Faruch Bilfeld
(M)
G Ferron
(G)
J Fontaine
(J)
L Fournier
(L)
E Gabiache
(E)
J Gagniere
(J)
D Geffroy
(D)
L Ghouti
(L)
F N Gilly
(FN)
L Gladieff
(L)
A Guibal
(A)
J M Guilloit
(JM)
F Guyon
(F)
B Heyd
(B)
C Hoeffel
(C)
C Hordonneau
(C)
S Isaac
(S)
P Jourdan Enfer
(P)
R Kaci
(R)
R Kianmanesh
(R)
C Labbé Devilliers
(C)
J Lacroix
(J)
B Lelong
(B)
A Leroux Broussier
(A)
Y Lherm
(Y)
R Lo Dico
(R)
G Lorimier
(G)
C Malhaire
(C)
F Marchal
(F)
P Mariani
(P)
E Mathiotte
(E)
P Meeus
(P)
E Mery
(E)
S Msika
(S)
C Nadeau
(C)
S Nougaret
(S)
P Ortega Deballon
(P)
B Paquette
(B)
O Pellet
(O)
P Peyrat
(P)
D Pezet
(D)
N Pirro
(N)
M Pocard
(M)
F Poizat
(F)
J Porcheron
(J)
P Rat
(P)
P Rousselot
(P)
P Rousset
(P)
H Senellart
(H)
M Serrano
(M)
V Servois
(V)
O Sgarbura
(O)
A Skanjeti
(A)
M Svrcek
(M)
R Tetreau
(R)
E Thibaudeau
(E)
Y Touchefeu
(Y)
J J Tuech
(JJ)
S Valmary Degano
(S)
D Vaudoyer
(D)
S Velasco
(S)
V Verriele Beurrier
(V)
L Villeneuve
(L)
F Zinzindohoue
(F)
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