Total pelvic exenterative surgery in patients with peritoneal metastases from appendiceal neoplasms. A case series of 2 patients.

Cytoreductive surgery Early postoperative intraperitoneal chemotherapy (EPIC) High grade appendiceal mucinous neoplasms Hyperthermic intraperitoneal chemotherapy (HIPEC) Low grade appendiceal mucinous neoplasms Pseudomyxoma peritonei Reoperative surgery

Journal

International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872

Informations de publication

Date de publication:
2019
Historique:
received: 26 04 2019
revised: 24 10 2019
accepted: 25 10 2019
pubmed: 23 11 2019
medline: 23 11 2019
entrez: 23 11 2019
Statut: ppublish

Résumé

Surgery which includes peritonectomy, visceral resections, and perioperative chemotherapy has been used extensively to treat peritoneal metastases from appendiceal mucinous adenocarcinoma. The results of treatment vary with the grade of the neoplasm, the extent of abdominal and pelvic disease and the completeness of tumor removal. The clinical features, surgical procedures and outcome of two patients with mucinous appendiceal neoplasms were reviewed. The decision to move to total pelvic exenterative surgery after prior treatment failure was critically evaluated. Patient 1 had three extensive surgical procedures prior to total pelvic exenteration and one surgical procedure after. Patient 2 had one 16-h surgical procedure prior to total pelvic exenteration. Patient 1 had 8 years and 1 month survival from onset of disease until death. Patient 2 is free of disease at 27 years from onset of pseudomyxoma peritonei. After recovery of the patients from the extensive surgery, their quality of life was acceptable. Total pelvic exenteration surgery is seldom used in patients with peritoneal metastases from appendiceal neoplasms. These two patients were studied in an attempt to determine the indications for this procedure with this disease.

Sections du résumé

BACKGROUND BACKGROUND
Surgery which includes peritonectomy, visceral resections, and perioperative chemotherapy has been used extensively to treat peritoneal metastases from appendiceal mucinous adenocarcinoma. The results of treatment vary with the grade of the neoplasm, the extent of abdominal and pelvic disease and the completeness of tumor removal.
METHODS METHODS
The clinical features, surgical procedures and outcome of two patients with mucinous appendiceal neoplasms were reviewed. The decision to move to total pelvic exenterative surgery after prior treatment failure was critically evaluated.
RESULTS RESULTS
Patient 1 had three extensive surgical procedures prior to total pelvic exenteration and one surgical procedure after. Patient 2 had one 16-h surgical procedure prior to total pelvic exenteration. Patient 1 had 8 years and 1 month survival from onset of disease until death. Patient 2 is free of disease at 27 years from onset of pseudomyxoma peritonei. After recovery of the patients from the extensive surgery, their quality of life was acceptable.
CONCLUSION CONCLUSIONS
Total pelvic exenteration surgery is seldom used in patients with peritoneal metastases from appendiceal neoplasms. These two patients were studied in an attempt to determine the indications for this procedure with this disease.

Identifiants

pubmed: 31756689
pii: S2210-2612(19)30611-X
doi: 10.1016/j.ijscr.2019.10.064
pmc: PMC6872774
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

279-283

Informations de copyright

Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Références

Int J Surg. 2018 Dec;60:279-282
pubmed: 30359781
Int J Hyperthermia. 2017 Aug;33(5):497-504
pubmed: 28540832
Int Semin Surg Oncol. 2005 Feb 08;2(1):3
pubmed: 15701175
J Gastrointest Surg. 2014 Apr;18(4):782-8
pubmed: 24203585
Lancet Oncol. 2006 Jan;7(1):69-76
pubmed: 16389186
Mod Pathol. 2001 Mar;14(3):164-71
pubmed: 11266521
J Surg Oncol. 2003 May;83(1):5-12; discussion 12-3
pubmed: 12722090
Eur J Surg Oncol. 2017 Jul;43(7):1228-1235
pubmed: 28189456
Ann Surg Oncol. 2013 Sep;20(9):2929-36
pubmed: 23666095
World J Surg Oncol. 2014 Sep 08;12:279
pubmed: 25200866
Ann Surg Oncol. 2014 Apr;21(4):1147-52
pubmed: 24356799
Ann Surg Oncol. 2007 Aug;14(8):2289-99
pubmed: 17541772

Auteurs

Paul H Sugarbaker (PH)

Program in Peritoneal Surface Malignancies, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC, 20010, USA. Electronic address: Paul.Sugarbaker@medstar.net.

Classifications MeSH