Systemic chemotherapy (SC) before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with peritoneal mucinous carcinomatosis of appendiceal origin (PMCA).
Eur J Surg Oncol
; 41(5): 707-12, 2015 May.
Article
in En
| MEDLINE
| ID: mdl-25633641
ABSTRACT
BACKGROUND:
The role of SC before CRS/HIPEC for patients with PMCA is unclear. This study explores the effect of SC prior to CRS/HIPEC on overall survival (OS) in patients with PMCA.METHODS:
72 patients with recently diagnosed PMCA who underwent CRS/HIPEC were identified from a prospective database. Thirty patients had SC before CRS/HIPEC (Group 1) and 42 did not (Group 2). Patients who were referred to our center after multiple lines of SC were excluded from this analysis. OS was estimated.RESULTS:
Median follow-up was 3.2 years. Groups were similar regarding lymph node positivity, postoperative SC and rate of complete cytoreduction. Twenty-four (80%) patients in Group 1 and 21 (50%) in Group 2 had high grade histology (HG) (p = 0.01). OS from CRS/HIPEC at 1, 2, and 3 years was 93, 68, 51% in Group 1 and 82, 64, 60% in Group 2, respectively (p = 0.74). Among HG patients 3-year survival was 36% in the SC group vs. 35% in the group without SC (p = 0.67). The 3-year OS for patients with low grade (LG) tumors was 100% in the SC group vs. 79% in the group with no prior SC (p = 0.26). Among patients with signet ring cell (SRC) histology, 1, 2 and 3-year survival was 94, 67 and 22% in the SC group vs. 43, 14, 14% in the group with no SC, respectively (p = 0.028). There were only 6 patients with LG PMCA who received prior SC.CONCLUSIONS:
Preoperative SC could improve the prognosis of patients with high-grade PMCA with SRC histology.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Appendiceal Neoplasms
/
Peritoneal Neoplasms
/
Peritoneum
/
Carcinoid Tumor
/
Antineoplastic Combined Chemotherapy Protocols
/
Carcinoma, Signet Ring Cell
/
Adenocarcinoma, Mucinous
/
Cytoreduction Surgical Procedures
/
Hyperthermia, Induced
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur J Surg Oncol
Journal subject:
NEOPLASIAS
Year:
2015
Document type:
Article