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Extensive surgical history prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is associated with poor survival outcomes in patients with peritoneal mucinous carcinomatosis of appendiceal origin.
Milovanov, V; Sardi, A; Aydin, N; Nieroda, C; Sittig, M; Nunez, M; Gushchin, V.
Afiliación
  • Milovanov V; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: vmilovan@mdmercy.com.
  • Sardi A; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: asardi@mdmercy.com.
  • Aydin N; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: naydin@mdmercy.com.
  • Nieroda C; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: cnieroda@mdmercy.com.
  • Sittig M; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: msittig@mdmercy.com.
  • Nunez M; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: mnunez@mdmercy.com.
  • Gushchin V; Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: vgushchin@mdmercy.com.
Eur J Surg Oncol ; 41(7): 881-5, 2015 Jul.
Article en En | MEDLINE | ID: mdl-25899982
ABSTRACT

BACKGROUND:

Patients with PMCA commonly undergo surgery before CRS/HIPEC. We evaluated the role of extensive surgical treatment before CRS/HIPEC in terms of overall survival (OS).

METHODS:

105 patients with PMCA who underwent a CRS/HIPEC procedure were identified from a prospective database. Patients were divided into two groups based on Prior Surgery Score (PSS) PSS ≤ 1 limited surgery group (LSG), PSS >1 extensive surgery group (ESG). Survival of lymph node (LN) negative and positive patients was analyzed separately.

RESULTS:

40 patients were in LSG and 65 in ESG. Mean time from diagnosis to CRS/HIPEC was 6 and 17 months for LSG and ESG, respectively (p = 0.004). Groups were well balanced in peritoneal cancer index, complete cytoreduction rate, and LN status. One, 3, and 5-year OS among LN negative patients was 95, 83, and 75% for the LSG (n = 22) group and 87, 55, and 32% for the ESG (n = 35), group respectively (p = 0.026). One, 3, and 5-year OS among LN positive patients was 69, 50, and 17% for the LSG (n = 18) group and 80, 21, and 14% for the ESG (n = 30), group respectively (p = 0.613). For all patients 1, 3, and 5-year OS was 84, 65, and 54% for the LSG (n = 40) group and 86, 43, and 26% for the ESG (n = 65) group, respectively (p = 0.029).

CONCLUSION:

Extensive surgical treatment before CRS/HIPEC is associated with delay of CRS/HIPEC and poorer OS overall, especially among LN negative patients. We recommend early referral of PMCA patients to a peritoneal surface malignancy center.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias del Apéndice / Neoplasias Peritoneales / Procedimientos Quirúrgicos Operativos / Quimioterapia del Cáncer por Perfusión Regional / Protocolos de Quimioterapia Combinada Antineoplásica / Adenocarcinoma Mucinoso / Abdomen / Procedimientos Quirúrgicos de Citorreducción / Hipertermia Inducida Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2015 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias del Apéndice / Neoplasias Peritoneales / Procedimientos Quirúrgicos Operativos / Quimioterapia del Cáncer por Perfusión Regional / Protocolos de Quimioterapia Combinada Antineoplásica / Adenocarcinoma Mucinoso / Abdomen / Procedimientos Quirúrgicos de Citorreducción / Hipertermia Inducida Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2015 Tipo del documento: Article