Extent of Disease on Visceral Peritoneal Surfaces of Mucinous Appendiceal Neoplasms Controls Survival.
CC score
EPIC
HIPEC
LAMN
PCI
appendicitis
cytoreductive surgery
hernia
peritoneal metastases
peritonectomy
Journal
Annals of surgery open : perspectives of surgical history, education, and clinical approaches
ISSN: 2691-3593
Titre abrégé: Ann Surg Open
Pays: United States
ID NLM: 101769928
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
22
04
2022
accepted:
28
06
2022
medline:
21
8
2023
pubmed:
21
8
2023
entrez:
21
8
2023
Statut:
epublish
Résumé
To determine causes of treatment failure of low-grade appendiceal mucinous neoplasms (LAMN). For 3 decades, LAMN have been treated by cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy. This combined treatment has resulted in a large change in the survival of these patients. A retrospective review of a prospectively maintained database was performed. A restricted cohort of patients with only LAMN histology and complete CRS were included in the statistical analysis. Four hundred and fifty patients were available with a median follow-up of 15.3 years (range 10-35 years). The median age was 49.7 and there were 196 males (43.6%). The mean survival was 24.5 years. Extent of parietal peritonectomy, resection of uterus, ovaries and apex of vagina had no impact on survival. Variables that indicated an increased extent of disease on visceral peritoneal surfaces had a significant impact on survival. Early postoperative intraperitoneal chemotherapy with 5-fluorouracil did not augment hyperthermic intraperitoneal chemotherapy (HIPEC). Patients who required reoperation for recurrence or patients with class 4 adverse events had a reduced prognosis. The mean survival of LAMN treated by complete CRS and perioperative chemotherapy was 24.5 years. Extent of disease quantitated on visceral peritoneal surfaces by the extent of visceral resections was the variable associated with treatment failure. Peritonectomy plus HIPEC was able to control disease on parietal peritoneal surfaces. Not only a larger extent of disease but also its location on visceral peritoneal surfaces controlled survival.
Sections du résumé
Objective
UNASSIGNED
To determine causes of treatment failure of low-grade appendiceal mucinous neoplasms (LAMN).
Background
UNASSIGNED
For 3 decades, LAMN have been treated by cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy. This combined treatment has resulted in a large change in the survival of these patients.
Methods
UNASSIGNED
A retrospective review of a prospectively maintained database was performed. A restricted cohort of patients with only LAMN histology and complete CRS were included in the statistical analysis.
Results
UNASSIGNED
Four hundred and fifty patients were available with a median follow-up of 15.3 years (range 10-35 years). The median age was 49.7 and there were 196 males (43.6%). The mean survival was 24.5 years. Extent of parietal peritonectomy, resection of uterus, ovaries and apex of vagina had no impact on survival. Variables that indicated an increased extent of disease on visceral peritoneal surfaces had a significant impact on survival. Early postoperative intraperitoneal chemotherapy with 5-fluorouracil did not augment hyperthermic intraperitoneal chemotherapy (HIPEC). Patients who required reoperation for recurrence or patients with class 4 adverse events had a reduced prognosis.
Conclusions
UNASSIGNED
The mean survival of LAMN treated by complete CRS and perioperative chemotherapy was 24.5 years. Extent of disease quantitated on visceral peritoneal surfaces by the extent of visceral resections was the variable associated with treatment failure. Peritonectomy plus HIPEC was able to control disease on parietal peritoneal surfaces. Not only a larger extent of disease but also its location on visceral peritoneal surfaces controlled survival.
Identifiants
pubmed: 37601148
doi: 10.1097/AS9.0000000000000193
pmc: PMC10431514
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e193Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Références
Eur J Surg Oncol. 2010 May;36(5):456-62
pubmed: 20227231
Adv Surg. 1996;30:233-80
pubmed: 8960339
Gastroenterol Res Pract. 2012;2012:623417
pubmed: 22654899
Ann Surg Oncol. 2012 Jan;19(1):110-4
pubmed: 21701929
Br J Surg. 2000 Aug;87(8):1006-15
pubmed: 10931042
J Surg Oncol. 2008 Nov 1;98(6):472-5
pubmed: 18770521
Am J Surg Pathol. 2016 Jan;40(1):14-26
pubmed: 26492181
Ann Surg. 1995 Feb;221(2):124-32
pubmed: 7857141
Ann Surg. 2007 Jan;245(1):104-9
pubmed: 17197972
Cancer Res. 1990 Sep 15;50(18):5790-4
pubmed: 2118420
Indian J Surg Oncol. 2016 Sep;7(3):295-302
pubmed: 27651688
Gastroenterol Res Pract. 2012;2012:471205
pubmed: 22548052
Ann Surg Oncol. 2020 Aug;27(8):2985-2996
pubmed: 32040698
Int J Hyperthermia. 2007 Aug;23(5):431-42
pubmed: 17701534
Cancer. 1988 Jan 15;61(2):232-7
pubmed: 3121165
J Clin Oncol. 2012 Jul 10;30(20):2449-56
pubmed: 22614976
World J Surg. 1994 Jan-Feb;18(1):150-5
pubmed: 8197772
Dis Colon Rectum. 2011 Mar;54(3):293-9
pubmed: 21304299
Ann Surg. 1995 Jan;221(1):29-42
pubmed: 7826158
Ann Surg Oncol. 2012 May;19(5):1386-93
pubmed: 22302270
Cancer Treat Res. 1996;82:415-21
pubmed: 8849965
Cancer J. 2009 May-Jun;15(3):225-35
pubmed: 19556909
Int Surg. 1991 Jul-Sep;76(3):164-7
pubmed: 1938205
Ann Surg Oncol. 2015 Apr;22(4):1274-9
pubmed: 25319583
Ann Surg Oncol. 2006 May;13(5):635-44
pubmed: 16523363
Anat Pathol. 1997;2:197-226
pubmed: 9575376